Background The liver is the most common site for distant colorectal cancer (CRC) metastasis, which develops in approximately one-third of CRC patients who undergo radical surgery. Hepatectomy for colorectal liver metastasis (CRLM) is the only potentially curative treatment for these patients. However, few metastatic CRC patients meet the criteria for this radical resection, and they have a low 5-year survival rate. Among those who undergo hepatectomy for CRLM, the recurrence rate is 60%. Thus, identifying risk factors for patients with CRLM is critical. One risk factor is non-alcoholic fatty liver disease (NAFLD), the incidence of which is increasing worldwide. NAFLD has become a main cause of chronic liver disease, and it is also an independent risk factor for CRC development. However, the effect of NAFLD on CRC liver metastasis after radical surgery remains unclear. The aim of this study was to retrospectively investigate the impact of NAFLD-associated hepatic fibrosis on liver metastasis after radical surgery for CRC. Methods We retrospectively analyzed data from 388 CRC patients with hepatic metastasis who underwent curative hepatectomy for CLRM at our hospital between April 2008 and March 2015. Data on each patient’s clinical results, surgical procedure, and postoperative course and their pathological and survival data were collected from our hospital records. The NAFLD fibrosis score (NFS) was also calculated, and patients were divided into two groups (NAFLD and non-NAFLD) on the basis of the NFS. Results Recurrence was observed in 83 (21.4%) of 388 patients after a mean follow-up 65.6 ± 15.1 months. Twenty-five patients had liver metastasis, and eight of them had NAFLD (8/45; 17.8%), while 17 of them (17/343; 5.0%) did not have NAFLD (p = 0.004). Additionally, liver metastasis-free survival in NAFLD patients was significantly worse than that in non-NAFLD patients (p < 0.001). We also showed that NAFLD and stage were independent risk factors for liver metastasis recurrence. Conclusions These results suggest that NAFLD may be a risk factor for liver metastasis in CRC patients who undergo curative surgery.

Anaplastic carcinoma of the pancreas (ACP) is an aggressive pancreatic tumor that grows rapidly, and its clinical characteristics are poorly defined because of its rarity. Thus, preoperative diagnosis is difficult and most definitive diagnoses are generally made by surgery, highlighting the importance of collecting more cases of ACP. We report a case of a 79-year-old woman with ACP that was difficult to diagnose preoperatively. Abdominal enhanced computed tomography revealed a large and expansive tumor in the spleen containing multilocular cystic and solid components. The first preoperative diagnosis was splenic angiosarcoma, and the tumor could be resected by distal pancreatectomy, total gastrectomy and partial transverse colectomy. ACP was first diagnosed based on postoperative histopathological findings. ACP that spreads to the spleen and forms an intrasplenic mass is rare. However, ACP should be included in the differential diagnosis of such patients, and further research of ACP is essential for a favorable prognosis.

Key Clinical Message Malignant peritoneal mesothelioma, a rare and poor prognosis disease, is seldom treated surgically, especially for recurrence. However, early diagnosis and aggressive treatment of primary and recurrent tumors can achieve long‐term patient survival. Abstract Malignant peritoneal mesothelioma (MPM) is a rare and aggressive tumor, and rarely indicated for surgery, especially for recurrence. In the present case, we report a rare case who could survive long‐term after two surgeries in 4 years for MPM.

Malignant peritoneal mesothelioma, a rare disease with a very poor prognosis, is seldom treated surgically, especially for recurrence. However, early diagnosis and aggressive treatment of primary and recurrent tumors, particularly the localized type of malignant peritoneal mesothelioma, can achieve long-term patient survival.