Yu WH, Zong Y, Zhou JW, Xu GQ. Uncommon causes of acute small intestinal bleeding-invasive mole: A case report and review of literature. World J Gastroenterol 2025; 31(41): 112794 [DOI: 10.3748/wjg.v31.i41.112794]
Corresponding Author of This Article
Guo-Qiang Xu, MD, Professor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. 1193065@zju.edu.cn
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Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 7, 2025 (publication date) through Nov 9, 2025
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World Journal of Gastroenterology
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1007-9327
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Yu WH, Zong Y, Zhou JW, Xu GQ. Uncommon causes of acute small intestinal bleeding-invasive mole: A case report and review of literature. World J Gastroenterol 2025; 31(41): 112794 [DOI: 10.3748/wjg.v31.i41.112794]
World J Gastroenterol. Nov 7, 2025; 31(41): 112794 Published online Nov 7, 2025. doi: 10.3748/wjg.v31.i41.112794
Uncommon causes of acute small intestinal bleeding-invasive mole: A case report and review of literature
Wei-Hua Yu, Yi Zong, Jiang-Wei Zhou, Guo-Qiang Xu
Wei-Hua Yu, Jiang-Wei Zhou, Department of Gastroenterology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Yiwu 322000, Zhejiang Province, China
Yi Zong, Department of Radiology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Yiwu 322000, Zhejiang Province, China
Guo-Qiang Xu, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Yu WH contributed to the manuscript writing and editing; Zong Y and Zhou JW contributed to the data collection; Yu WH, Zong Y, and Zhou JW contributed to data analysis, Xu GQ contributed to the conceptualization and supervision; and all authors read and approved the final manuscript.
Informed consent statement: An informed written consent was obtained from the patient for the publication of this report, and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Qiang Xu, MD, Professor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. 1193065@zju.edu.cn
Received: August 7, 2025 Revised: September 7, 2025 Accepted: September 28, 2025 Published online: November 7, 2025 Processing time: 92 Days and 4.3 Hours
Abstract
BACKGROUND
Gastrointestinal bleeding due to metastasis of an invasive mole to the small intestine is very rare. Most reported cases of metastatic invasive mole are diagnosed after surgery, and lack rich illustrations, which leads to insufficient understanding by clinicians, misdiagnosis, and unnecessary surgeries.
CASE SUMMARY
A 22-year-old female patient presented with bloody stool and elevated human chorionic gonadotropin. The transvaginal gynecological ultrasound ruled out pregnancy. Upper gastrointestinal endoscopy and colonoscopy were performed, but no bleeding focus was detected. The contrast-enhanced computed tomography was unremarkable. The capsule endoscopy suggested jejunal protuberant lesions with dark red blood clots. Therefore, oral single-balloon enteroscopy was performed, and two connected protuberant lesions were detected, with blood clot traces and local ulceration. The enteroscopic biopsy revealed trophoblastic cells with a probable diagnosis of trophoblastic tumor. The patient underwent surgical resection of the diseased jejunum. Intraoperative endoscopy was performed, and the findings were the same as those of the small intestine endoscopy. The postoperative pathology confirmed the preoperative diagnosis of invasive mole.
CONCLUSION
In non-pregnant women with elevated human chorionic gonadotropin and gastrointestinal bleeding, metastatic trophoblastic neoplasia should be considered.
Core Tip: Gastrointestinal bleeding due to small intestinal tumors, especially metastatic tumors, is rare. We describe a rare case of metastatic invasive mole that caused acute small intestinal bleeding. The capsule endoscopy and enteroscopy detected jejunal lesions with features of trophoblastic tumor on biopsy. The patient underwent resection of the involved jejunal segment. The histopathology of the resected specimen confirmed the diagnosis of invasive mole. For women of childbearing age, who present with gastrointestinal bleeding and elevated human chorionic gonadotropin, after pregnancy is ruled out, metastatic trophoblastic tumor must be included in the differential diagnoses.
