A Sheep in Wolf\'s Clothing—The Enigmatic Uterine Giant: A Surgical Dilemma in a Perimenopausal Woman

Gestational trophoblastic disease (GTD) encompasses a spectrum of disorders ranging from benign hydatidiform mole to malignant choriocarcinoma.Diagnosis is often straightforward, but atypical presentations may mimic other uterine malignancies, creating diagnostic and therapeutic dilemmas.We present a rare case of a perimenopausal woman with a large intrauterine mass, markedly elevated serum -hCG, and an inconclusive preoperative biopsy, who underwent total laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH-BSO).Histopathology confirmed a complete hydatidiform mole (CHM).This case highlights the importance of individualized surgical decision-making in atypical GTD presentations.