{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:07:24Z","timestamp":1790968044547,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,26]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>Gestational trophoblastic disease occurs in 1\u20133:1000 gestations worldwide. Up to one-fifth of complete hydatidiform moles undergo malignant transformation, with 2%\u20134% manifesting as metastatic disease. Of these, a third present with vaginal metastases, which can cause bleeding and discharge. We describe the case of a 49-year-old primiparous woman presenting with syncope and intense bleeding from an anterior vaginal lesion, 3\u2009weeks after uterine evacuation for a presumed spontaneous abortion. A vaginal metastatic nodule was suspected; haemostasis was achieved with vaginal packing, precluding the need for surgical intervention. The patient was ultimately diagnosed with invasive mole with vaginal and lung metastases (stage III high-risk gestational trophoblastic neoplasia (GTN)) and started on multiple-agent chemotherapy. Two months later the lesion had regressed completely, and remission was reached 2\u2009weeks later. Clinicians should consider the possibility of metastatic GTN with vaginal involvement whenever heavy vaginal bleeding follows a recent history of failed pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2021-242208","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T12:12:44Z","timestamp":1624277564000},"page":"e242208","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Invasive mole presenting as a heavily bleeding vaginal lesion 3 weeks after uterine evacuation"],"prefix":"10.1136","volume":"14","author":[{"given":"Rita","family":"Mamede","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Beja","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Department, Centro Hospitalar de Lisboa Ocidental 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