Rupture of liver myelolipoma in a patient who underwent mitral valve replacement 16 years ago: A case report

Myelolipoma is a rarely encountered benign tumour of the liver. Patients may be asymptomatic or may present with clinical signs such as silent hepatomegaly, pain in the right upper quadrant of the abdomen, and anorexia. The patient, who had a history of mitral valve replacement, had been on warfarin for 16 years. The pain, which began in the right upper quadrant of the abdomen two days ago, has since spread to the entire abdomen. The patient, who was in hypovolemic shock, underwent an exploratory laparotomy with a preliminary diagnosis of bleeding. During the procedure, a ruptured mass in the liver was incidentally discovered. Histopathological and immunohistochemical examinations revealed that the mass consisted of fat and bone marrow cells, leading to a definitive diagnosis of myelolipoma. To the best of our knowledge, this is the first reported case of spontaneous rupture of a liver myelolipoma in the literature.