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Background & Aims Long‐term outcomes after percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) in patients with non‐alcoholic fatty liver disease (NAFLD) have been poorly studied. We aim to determine the outcomes after multibipolar RFA in these patients compared to other aetiologies as well as the prognostic impact of metabolic syndrome (MS). Methods Patients who underwent multibipolar RFA as the first treatment for HCC within Milan criteria (2008‐2018) were enrolled in this multicentre retrospective cohort from four tertiary centres in France. The association of MS and NAFLD with adverse events and outcomes after percutaneous RFA were assessed using Kaplan Meier method, log‐rank test and uni/multivariate analysis with the Cox models. Results Among 520 patients, 390 patients (75%) had at least one component of MS including obesity (30%) and 95% had cirrhosis. Sixty‐two patients (12.6%) had NAFLD‐HCC, 225 (45.5%) had alcohol‐related‐HCC, 36 (7.3%) had HBV‐HCC and 171 (34.6%) had HCV‐HCC. Patients with NAFLD‐HCC were significantly older (median age 72.6 years, P < .001), more obese (median BMI 30.3 kg/m2, P < .001) and had more components of MS. Patients with NAFLD‐HCC achieved a median overall survival (OS) of 79 months (1‐year, 3‐year and 5‐year OS of 90%, 71% and 59%). There were no differences in morbidity, tumour recurrence and OS among patients with NAFLD‐HCC vs other aetiologies as well as no prognostic impact of metabolic components. Conclusions Percutaneous multibipolar RFA is an efficient treatment in HCC patients with NAFLD or metabolic syndrome and achieved similar long‐term oncological outcomes compared to other aetiologies.

Introduction. The optimal initial management of parotid pleomorphic adenomas reduces the risk of recurrence and malignant transformation. Surgery of recurrence can be difficult in multinodular disseminated forms. Case Report. A 67-years-old patient was referred for management of a large multifocal recurrence of a pleomorphic adenoma operated on 23 years ago. The clinical and radiological assessment found parapharyngeal, infratemporal, and prestyloid invasion, with nodules in the sternocleidomastoid muscle. Excision by transmandibular approach was performed. The pathologist found a multinodular recurrent pleomorphic adenoma without criteria of malignancy. Postoperative radiotherapy was performed. Discussion. Multinodular forms and incomplete resections are the most important factors that are thought to predispose to recurrence. A precise analysis of the extension by preoperative MRI is essential. Adjuvant radiotherapy can be given in these recurrent multifocal forms.

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