Although the tumor was estimated to be anatomically resectable, we introduced preoperative adjuvant chemotherapy with atezolizumab and bevacizumab to reduce tumor viability because the patient’s protein induced by vitamin K absence or antagonist II (PIVKA-II) level was remarkably high at 14,683 mAU/mL while his alpha-fetoprotein (AFP) level was normal (2.2 ng/mL). The gene discussed is AFP; the disease is neoplasm.