What is an Invasive Mole of the Uterus?An invasive mole of the uterus, also known as a chorioadenoma destruens, is a rare form of the gestational trophoblastic disease (GTD), a group of conditions in which abnormal cells grow inside the uterus following conception. While a mole begins as an abnormal pregnancy, in rare instances, this tissue abnormal tissue can invade the muscular layer (myometrium) of the uterus, and in rare cases, can penetrate through the wall of the uterus to nearby structures or distant sites (metastasis). Invasive mole of the uterus can develop into a form of GTD known as choriocarcinoma.
Disease Aetiology (Causes)An invasive mole of the uterus results from an abnormal fertilisation event. In the majority of cases, all genetic material comes from the father, with the egg either containing no genetic material or the maternal contribution being deactivated. The precise reason for this abnormal fertilisation is unknown. Risk factors include a previous molar pregnancy, maternal age (under 20 or over 35), and certain dietary deficiencies.
DiagnosisThe diagnosis of an invasive mole of the uterus often involves:
- Detailed medical history and physical examination
- Ultrasound, which may reveal a cluster of cysts in the uterus
- Blood tests to measure levels of human chorionic gonadotropin (hCG), a hormone typically elevated in molar pregnancies
TreatmentThe treatment for an invasive mole of the uterus typically involves:
- Dilation and curettage (D&C): A surgical procedure to remove abnormal tissue from the uterus.
- Chemotherapy: Often used after surgery if hCG levels do not return to normal, indicating that molar tissue may still be present.
- Monitoring hCG levels: Following the surgical treatment, hCG levels in the blood are regularly monitored until they return to normal, to ensure that all the molar tissue has been removed.