Vesicular Mole with Myometrial Invasion: A Case Report

Abstract

Invasive vesicular mole (chorioadenoma destruens) is a rare form of Gestational Trophoblastic Disease (GTD) characterised by abnormal trophoblastic proliferation and myometrial invasion. The authors report the case of a 42-year-old multiparous woman who presented with prolonged vaginal spotting, amenorrhoea and elevated Beta-Chorionic Gonadotropin (HCG) levels (1,260,350 mIU/mL). Ultrasound and Magnetic Resonance Imaging (MRI) findings revealed a heterogeneous endometrial mass with myometrial thinning, raising suspicion of gestational trophoblastic neoplasia. The patient was started on multi-agent chemotherapy {Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide and Oncovin (EMACO)} due to high beta-hCG levels. However, persistent bleeding and imaging findings of residual disease necessitated surgical intervention. Histopathology confirmed an invasive vesicular mole with myometrial invasion. Postoperatively, beta-hCG levels declined to undetectable levels (<5 mIU/mL) and the patient was discharged in stable condition with close follow-up. Invasive vesicular mole is a rare but aggressive form of GTD that requires prompt diagnosis and treatment. Early initiation of chemotherapy and tailored intervention can lead to successful outcomes with normalisation of beta-hCG levels.

Keywords

• chemotherapy
• choriadenoma destruens
• gestational trophoblastic disease
• molar pregnancy
• neoplasia