Due to the significant epithelioid morphology and atypia of hepatic epithelioid angiomyolipoma (HEAML), intraoperative frozen section pathologic diagnosis might be challenging.<h4>Case presentation</h4>A 33-year-old woman was admitted to our hospital for elevated alpha-fetoprotein (AFP) levels after a regular checkup following breast cancer surgery. The gene discussed is AFP; the disease is breast carcinoma.