Invasive mole is a form of persistent or metastatic gestational trophoblastic disease presenting usually after hydatiform mole 6-10 times more common than choriocarcinoma. It is defined as molar gestation invading the myometrium or uterine vessels. Persistent vaginal bleeding after evacuation of molar pregnancy and persistent elevation of beta HCG . The presentation of secondaries is after few months to years in choriocarcinoma but immediately in cases of invasive mole .
The following case is a spectrum showing a diagnostic dilemma between choriocarcinoma or invasive mole or a consistent finding of AV malformation in the ultrasonography because of lack of an initial histopathological evidence of molar pregnancy from the evacuated products of conception and also posed a difficulty in deciding the mode of treatment considering the age of the patient whether conservative or radical surgery.