In clinical practice, although biopsy is recommended by the guidelines (e.g., International Childhood Liver Tumors Strategy Group (SIOPEL) guideline and Expert Consensus for Multidisciplinary Management of Hepatoblastoma (CCCG-HB-2016) protocol), some investigators consider that it may not be necessary for young children (6 months to 3 years of age) with a very high alpha-fetoprotein (AFP) level [7, 8]. Here, AFP is linked to hepatoblastoma.