This patient is a known case of molar pregnancy presented for follow up. Previous serial B-HCG levels demonstrated regression and on the 7th-week post evacuation a rise in B-HCG levels was noted; ( pre-evacuation reading was ~ 430000 IU/L, two weeks post-evacuation it was ~ 1000 IU/L and on the 7th-week it was ~ 3000 IU/L).
Pan CT scan was requested to rule out metastasis. A suspicious highly vascular lesion is seen invading the myometrium without detectable metastatic lesions.
In correlation with the clinical scenario, rising B-HCG levels and presence of chorionic villi in the histopathology specimen (which rules out choriocarcinoma)1, features are most suggestive of invasive molar pregnancy.
The patient was started on chemotherapy, and B-HCG levels are declining.