Mola invasora y abdomen agudo: a propósito de un caso

Summary asive mole is an eventual complication of the partial or complete hydatidiform mole. It presents as a deep invasion of chorionic villi with hydropic degeneration and trophoblastic structures in the myome-trium or invasion of the uterine vessels. The majority derive from a complete mole, although it has also been described in partial moles and has a 10 times lower frequency. gnosis is based on analytic suspicion: a progressive increase in (βhCG and by imaging: ultrasound scan with or without Doppler and/or uterine magnetic resonance. The main risks of invasive mole are: severe uterine bleeding, uterine perforation which causes haemoperitoneum and acute abdomen, and progression to choriocarcinoma. With suitable cytotoxic chemotherapy (Methotre-xate or Acintomycin D) the prognosis is excellent, with almost 100% recovery. We present the clinical case of a 27 year old woman with an invasive mole which caused uterine perforation with haemoperitoneum and acute abdomen which required surgery. Conservative surgery was carried out by resection and suture of the uterus, in the place where the mole was implanted. Following this, Methotrexate 73 mg intramuscular/ per week during 8 weeks was administered. The patient has been asymptomatic for 16 months, with negative (β-hCG and normal pelvic scan, and is trying to become pregnant again.