Differentiating hepatoblastomas (HB) from other congenital benign hepatic tumours prior to surgical management decisions is key. We, herein, present an unusual case of an antenatally diagnosed liver lesion assessed in the neonatal period. Because of its predominantly cystic ultrasound/MRI appearance and borderline alpha-fetoprotein serum levels, the diagnosis of mesenchymal hamartoma was favoured and protocol-based tumor resection was performed. Due to the intra-operative diagnosis of fetal subtype HB with positive resection margins the child had to undergo a second laparotomy. This report raises awareness to an unusual appearance of HB and discusses non-invasive imaging clues to consider atypical appearances of HB pre-operatively as they can have profound implications in patient management.