SMILE is almost always associated with additional HPV-related neoplastic lesions although only one patient (3%) had invasive carcinoma, a lower rate than recorded in other studies. Consistent cytologic features associated with SMILE were identified but these were relatively subtle. However, increased awareness of these features may permit prospective diagnosis and this could influence patient management.
HighlightsMassive phyllodes tumour has a higher chance of being malignant.Staging imaging is undertaken to confirm and define local chest wall invasion.An associated silent DVT/pulmonary embolism should be considered.Pre-operative diagnosis of DVT/Pulmonary embolism changes peri-operative planning.Peri-operative morbidity/mortality is reduced by recognising DVT/Pulmonary embolism.
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