A vesicular mole may be followed by an invasive mole with this unusual presentation. So in the case of irregular menses post evacuation, rising B-hcg , HB 11gm% and an empty uterine cavity upon ultrasound, what should be the management with regards to diagnosis and treatment?
Uterine arteriovenous malformation with GTD is a very uncommon disorder and can be diagnosed by arteriography or color Doppler. 20% of complete moles can go for invasion .Invasive moles (chorioadenoma destruens) are locally invasive, rarely metastatic lesions characterized microscopically by trophoblastic invasion of the myometrium with identifiable villous structures. Patients have persistent vaginal bleeding with elevated βhCG titres post evacuation. Histopathology is the only confirmatory evidence of invasion. Invasive moles also have shown to have spontaneous regression or may need methotrexate treatment .
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