Angiographic-guided embolization of metastatic invasive mole

The friable and hypervascular nature of a metastatic invasive mole places the patient at risk for significant hemorrhage. Bleeding is the chief cause of morbidity and mortality in patients with a histopathological diagnosis of invasive mole. Bleeding from vaginal metastatic lesions can be controlled by packing the vagina and local excision if necessary. Often the results are less than satisfactory.

This case describes a 43-year-old Hispanic female with metastatic invasive mole to the vagina. Following chemotherapy, she underwent life-threatening hemorrhage requiring hospitalization and multiple transfusions. The metastatic lesions were successfully embolized with gelfoam by selective angiography. The patient required minimal additional chemotherapy and is currently without evidence of disease.

The technique of angiographic embolization is emerging as a successful and minimally invasive procedure as illustrated in this presentation. Prophylactic embolization with or prior to the administration of chemotherapy in the management of metastatic invasive mole is discussed and may play a role in the primary therapy of this condition.