Abstract
INTRODUCTION AND IMPORTANCE: Invasive mole is a rare subset of gestational trophoblastic neoplasia (GTN), occasionally arising from a partial molar pregnancy. If untreated, it may lead to severe complications, including uterine invasion and hemorrhage. CASE PRESENTATION: We report a 44-year-old woman with persistent vaginal bleeding and rising β-hCG levels following the evacuation of a partial hydatidiform mole. Despite methotrexate therapy, the disease progressed, necessitating hysterectomy due to hemorrhagic complications. Histopathology confirmed an invasive mole. Postoperatively, β-hCG remained elevated, and the patient experienced recurrent bleeding and metastatic spread to the vaginal vault, requiring further surgical intervention. CLINICAL DISCUSSION: Although progression to an invasive mole is uncommon after a partial mole, this case demonstrates the potential for aggressive behavior and resistance to first-line chemotherapy. The clinical course emphasizes the importance of close β-hCG surveillance and timely multidisciplinary intervention. CONCLUSION: This case underlines the need for vigilant follow-up after molar evacuation, especially in patients with rising β-hCG, and highlights the role of surgery when medical treatment fails.