55 year‐old male who undergoes surgery for an umbilical hernia (BMI = 24; serum albumin 3.8 g/dL) with good performance status (ECOG = 1) who is found to have nodules in the excised hernia sac, and pathology is consistent with epithelioid malignant peritoneal mesothelioma. The gene discussed is ALB; the disease is Umbilical hernia.