Several predisposing factors were identified for the occurrence of POMC, including preoperative bulbar symptoms, intraoperative blood loss >1000 mL, preoperative serum level of anti-acetylcholine receptor antibody >100 nmol/L,[14] and WHO histologic classification B2–B3 thymoma.[13] Accordingly, the risk factors for POMC in our patient included the presence of preoperative bulbar symptoms and WHO histologic thymoma grading of B2. The gene discussed is POMC; the disease is thymoma.