Invasive mole

Invasive mole (also known as chorioadenoma destruens) is a form of gestational trophoblastic neoplasia (GTN) that arises from abnormal placental tissue, most commonly following a hydatidiform mole (molar pregnancy). In this condition, molar tissue invades into the muscular wall of the uterus (myometrium) and may occasionally spread to nearby structures or, rarely, to distant sites such as the lungs or vagina. It is classified as a malignant form of gestational trophoblastic disease but generally carries a favorable prognosis with appropriate treatment. The condition primarily affects the reproductive system. Key clinical features include persistent or irregular vaginal bleeding following evacuation of a molar pregnancy, an abnormally elevated or plateauing serum beta-human chorionic gonadotropin (β-hCG) level, and uterine enlargement. Imaging studies such as ultrasound or MRI may reveal myometrial invasion. In some cases, theca lutein ovarian cysts may be present due to high hCG stimulation. Invasive mole is highly responsive to treatment. The primary approach is chemotherapy, most commonly single-agent methotrexate or actinomycin D for low-risk disease, with multi-agent chemotherapy regimens reserved for high-risk or resistant cases. Hysterectomy may be considered in select patients, particularly those who have completed childbearing or in cases of life-threatening hemorrhage. With appropriate management, cure rates approach nearly 100%. Regular monitoring of serum β-hCG levels is essential during and after treatment to confirm remission and detect any recurrence. Patients are typically advised to avoid pregnancy for a defined period following treatment to allow accurate hCG surveillance.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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