Clinically, mediastinal tumors with a diameter greater than 10 cm are generally referred to as giant mediastinal tumors. Because of its deep location, it is very difficult to operate. One patient from Kulle, Xinjiang had a tumor located in the anterior mediastinum, which had significantly compressed the trachea, heart, large blood vessels and other surrounding organs, resulting in chest tightness and shortness of breath. The tumor compressed the superior vena cava, resulting in obstruction of blood return to the upper body and swelling of the head and face of the patient. The pressure on the heart became increasingly severe and life-threatening at any time, and the patient was unable to lie flat for two months. The patient was treated by a local doctor and was said to be inoperable. He was referred to several tertiary hospitals across the country, all of which indicated that surgical treatment was not possible. After studying the patient’s imaging data, it was concluded that although the anesthesia was extremely risky and the surgery was extremely difficult, the patient needed to be operated on in the fastest possible time in order to save his life. Before the operation, Dr. Wang Yingwei, the director of the Department of Anesthesiology, and Dr. Shen Sai’e, the deputy chief physician of the Department of Anesthesiology, consulted the patient and concluded that the tumor was huge and the trachea was severely collapsed, which made anesthesia extremely risky. Through thorough preoperative preparation and cooperation with the Department of Anesthesiology, the patient was successfully operated in our department. Despite the thorough preoperative preparation, the patient’s blood pressure, heart rate and oxygen saturation decreased progressively during the induction of anesthesia. The patient’s blood pressure, heart rate and oxygen saturation were stabilized. During the operation, the patient underwent wedge resection of the left and right upper lungs and partial pericardial resection because the tumor invaded the left and right upper lungs. The tumor was completely removed and the thoracic reconstruction was completed, which removed the mountain that was pressing the patient’s chest, relieved the tumor’s pressure on the patient’s trachea, heart and large blood vessels, and eliminated the patient’s symptoms of chest tightness and shortness of breath, and the patient recovered smoothly after surgery. As mediastinal tumors often have no obvious clinical symptoms, it is not easy to attract patients’ attention. They are often found during physical examination or come to the hospital only when the tumors compress important tissues and organs and show corresponding clinical symptoms. The cardiothoracic surgery department of Xinhua Hospital performs about 150 cases of mediastinal tumors every year, among which about 30 cases are huge mediastinal tumors. Most of them can be treated by minimally invasive thoracoscopic surgery, which is the leading level in China with small trauma and fast recovery.