Abstract
Cancer of ampulla of Vater showed a favorable prognosis compared to that with the other periampullaly lesions. Ampullary tumor tends to show local invasions without skip lesion along with the mucosa of extra-hepatic bile duct. We reported a first case with early ampullary cancer with skip lesion. Main and minor lesions existed together intermitted with normal mucosa of the bile duct. Regarding the detection for lesions, EUS had a diagnostic value. IDUS failed the accurate depth of the main lesion due to the inflammatory change. For a difficult case to diagnose, it was thought that 3D restructuring was necessary. There were no differences as for p53 immune reactivity in the resected specimen between the major and the minor tumors.
