UTERINE ARTERIOVENOUS MALFORMATION FOLLOWING GESTATIONAL TROPHOBLASTIC NEOPLASIA AFTER COMPLETE HYDATIDIFORM MOLE: A CASE REPORT

Background: Uterine arteriovenous malformation (UAVM) is a rare vascular abnormality that may occur following uterine instrumentation or in association with gestational trophoblastic disease (GTD). Its diagnosis is particularly challenging during post-molar follow-up, as imaging findings may mimic persistent trophoblastic neoplasia. Case Presentation: We report the case of a 42-year-old woman diagnosed with a complete hydatidiform mole with an initial serum β-hCG level of 650,000 IU/L. Following suction evacuation, the patient developed gestational trophoblastic neoplasia and was treated with methotrexate, achieving complete normalization of β-hCG levels at the end of treatment. Four months after uterine evacuation, she presented with metrorrhagia. Pelvic Doppler ultrasonography revealed a uterine arteriovenous malformation. Given the absence of biological evidence of persistent trophoblastic disease and the patient\'s hemodynamic stability, a conservative approach with close clinical and ultrasonographic surveillance was adopted. The patient experienced progressive resolution of vaginal bleeding without the need for invasive intervention. Conclusion: Uterine arteriovenous malformation should be considered in patients presenting with abnormal uterine bleeding during follow-up of gestational trophoblastic disease, even after complete β-hCG normalization. Doppler ultrasonography plays a key role in diagnosis, while conservative management may be a safe and effective option in selected clinically stable patients. Keywords: Gestational trophoblastic neoplasia; Complete hydatidiform mole; Uterine arteriovenous malformation; Doppler ultrasonography; Methotrexate; Conservative management.