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Customer brought his truck in prior with the complaint of it running rough. I plugged into it with my scan tool and found the rail pressure was spiking at idle to well past 20k psi. This is almost always a sign that the FCA (fuel control actuator) is failing.
When a fuel control actuator fails, it is designed to fail open, or "full fuel". If left unrepaired for an extended period of time, this can cause injector failures as well as damage to the pistons.
After replacing the FCA, the truck ran great for about a month. It then had a catistrophic piston failure in number 6. The injector was pumping fuel into the cylinder, which was vaporizing in the crank case. It was also pumping that fuel and oil out the number 6 exhaust.
What most likely happened, was the failed FCA, along with a failing injector was causing damage to the top of the piston. By the time the FCA was replaced, the damage was too severe. The piston eventually "melted" away enough to create a hole between the top of the piston and the ring as shown. There was also a large score in the cylinder wall, due to a broken ring.
The customer opted for a long block from Industrial Injection.
The engine was replaced and the job completed along with a new clutch and other components.

The Ford 6.7L runs the CP4 high pressure fuel pump. This pump designed internally with many flaws. It allows case drain to enter the supply to the rail. Due to this fact, when the CP4 fails, it will most likely take out the rest of the fuel system with it. This kit is the cheaper solution compared to a CP3 or DCR conversion. It blocks the pump's ability to send metal to the rail, while also filtering that return before it enters the cooler/tank.

Replacing the inner axle seals on these trucks requires a full axle teardown. Even the carrier must be removed.
Installing the seals properly requires specialty tools and special care to clean/debur the axle housing.