CLDN18 and neoplasm: This study has several limitations: (1) The original immunohistochemistry report confirming CLDN18.2 positivity from the referring hospital was unavailable, so it is impossible to explain the specific expression level of CLDN18.2, meanwhile, the PD-1/PD-L1 status of the initial endoscopic biopsy remains uncertain(However, given the PD-L1 negativity observed in the tumor tissue resected during the final oophorectomy, it is likely that the primary lesion was also PD-1/PD-L1 negative).