In clinical practice, mediastinal tumors with a diameter greater than 10 cm are generally called giant mediastinal tumors. Because of its deep location, it is very difficult to operate. Recently, the cardiothoracic surgery department of Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine successfully performed resection surgery for a patient with a huge mediastinal tumor with a diameter of more than 20 cm, removing the “mountain” that was pressing on the patient’s heart in one stroke. The tumor of this patient from Kulle, Xinjiang was located in the anterior mediastinum, which had obviously compressed the trachea, heart, large blood vessels and other surrounding organs, causing the patient to have chest tightness and shortness of breath, and the tumor compressed the superior vena cava, causing the patient’s blood return to the upper body to be blocked and the head and face to be swollen. 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 went to many tertiary hospitals across the country, but each hospital said he could not be treated surgically. Prof. Mei Ju, Director of Cardiothoracic Surgery, Xiao Haibo, Deputy Chief Physician, and Xie Xiao, Attending Physician of Xinhua Hospital, studied the patient’s imaging data in detail and concluded that although the anesthesia was extremely risky and the surgery was extremely difficult, it was necessary to operate on him 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, considered that the patient’s 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.