Huge thoracic tumor, which almost occupies one side of the thoracic cavity and can be completely removed and cured by surgery is rare; huge pleural confined fibrous tumor is a rare (rare) thoracic tumor; now we report a case of huge pleural confined fibrous tumor in the thoracic cavity: the tumor was completely removed by open-heart surgery, and the general condition recovered rapidly to normal, with no recurrence and metastasis and healthy body in nearly three years of follow-up. It is the largest tumor among the cases of pleural confined fibrous tumor surgically resected in our hospital; it is also the case with the best recent postoperative effect (good physical recovery, no tumor recurrence and no metastasis, long follow-up time and survival time) among the cases of surgically resected giant thoracic tumor. The patient was a young male, 39 years old. He had chest tightness and shortness of breath for more than half a month, with hypothermia and loss of work capacity. CT examination showed that the left thoracic giant tumor occupied almost the whole left thoracic cavity, with a cross-sectional size of about 16×7.0 cm; the lower lobe of the left lung was compressed and undistended; the left thoracic effusion, and the pleural fluid was light blood, but the investigation of tumor cells and tumor series were negative, and the diagnosis of thoracic malignant tumor, malignant pleural mesothelioma was made. Pulmonary function test: mixed pulmonary ventilation dysfunction and severe small airway dysfunction. He was admitted to the First Hospital of China Medical University at the end of December 2008 in the hope of receiving surgical treatment after failing to be treated at several hospitals in Inner Mongolia, Jilin and Liaoning. The difficulty of surgical treatment is self-explanatory. The tumor is large and extensive, and the large surgical trauma may lead to postoperative bleeding and even chest bleeding and require second open-heart surgery; after opening the chest, the tumor may be found to be seriously invasive and cannot be removed or not completely removed, so that the desired surgical purpose cannot be achieved; after removal of the huge tumor, postoperative pulmonary reopening and pulmonary edema induced cardiopulmonary failure endanger the life, etc.; although the patient is young, he is depleted and in poor general condition because of the huge tumor. Although the patients are young, they have poor physical strength, poor body resistance and poor cardiopulmonary function, all of which are unfavorable factors in terms of their ability to withstand the blows caused by surgery and their ability to recover after surgery, all of which increase the risk of the surgery itself and the risk of life-threatening complications such as postoperative pulmonary hypofunction, pulmonary infection and chest infection, and even cardiopulmonary failure. In the event of complications, even relatively minor ones that can be overcome through active treatment, the financial burden on the patient and family may increase exponentially; and in the event of more serious and potentially life-threatening complications, such as severe pulmonary infection or cardiopulmonary failure, which are likely to occur in this case, even in terms of financial burden alone, it will be a “disaster” for any ordinary family “This has caused doctors to believe in professional ethics, bravely face and actively treat patients with difficult and serious illnesses, which is a normal and just medical practice that should be advocated and encouraged in any medical environment. Immediately into an awkward situation, and even trigger the discontent of the patient’s family and even the so-called “trouble”, “disputes”, but to bring negative impact on the hospital, treating doctors to be seriously criticized and even punished. Safety, patient safety, for medical work, for the department and even the hospital is always the top priority, not to mention the end of the year, the New Year will come, the Spring Festival will come, peace and quiet to send the old year, happy to welcome the New Year, for any country is of great significance. But the condition cannot wait, the patient’s big tumor is growing day by day and the patient’s condition is getting worse day by day. Patients and their families are very straightforward in their thinking. They urgently demand for surgery and think that as long as doctors operate, they should be able to remove the tumor and hope to live and go home for the New Year as soon as possible. In the face of difficult problems, surgeons always need to consider carefully, not only dare to take the responsibility, try to achieve technical excellence and successful surgery, but also have good psychological quality and must have the psychological ability to face unsatisfactory surgical results and even surgical failure; they must be prepared for any serious complications such as intraoperative and postoperative hemorrhage, secondary surgery, cardiopulmonary failure, etc., and actively resuscitate and save the patient’s life. We must be prepared to avoid complications and reduce the economic burden of patients and their families as much as possible. After careful preparation and many collective discussions within the department, the department unanimously agreed to the surgical treatment. We again fully communicated with the patient and his family about the risks of surgery and sought their consent, and performed left-sided open-heart surgery under general anesthesia in January 2009. The tumor was attached to the lateral chest wall, reaching the top of the pleura, occupying the sinus of the rib diaphragm below, and occupying almost the whole left chest cavity, about 22×15×7cm3; because the tumor was huge, protruding and occupying the whole operation field, the conventional operation incision could not be operated, and there was no way to start. In order to completely remove the tumor, to avoid squeezing the tumor, to avoid cutting the tumor in the chest cavity, and to avoid possible hemorrhage caused by blind separation, the incision was slightly enlarged, and the upper and lower ribs were cut off to expand the operation field to a limited extent to facilitate the operation, to carefully free the tumor little by little, to stop bleeding exactly, to prevent excessive bleeding during the operation and bleeding from the chest wall after the operation, to minimize surgical trauma, to gradually free the tumor completely, and to hold the tumor by hand to avoid its direct compression of the heart and large blood vessels, which caused Finally, the huge tumor in the left chest was removed as a whole, together with part of the upper lobe of the left lung and part of the lower lobe of the left lung connected with the tumor, in order to ensure the thoroughness of the tumor removal and to preserve as much normal lung tissue as possible, that is, to adhere to the principle of “maximum tumor removal and maximum preservation of normal lung tissue”. “The operation was very satisfactory and successful. The resected tumor was hard and tough, substantial, and weighed more than 2 Kg. Postoperative pathological diagnosis: pleural confined fibrous tumor (low grade malignancy). After the patient learned that the surgery was successful, he was in a very happy mood every day and his recovery went very well. Now, two years and eight months after the operation, the patient looks rosy, has gained weight, has a good mental and physical state, has fully returned to normal life and is capable of physical labor; he is very satisfied with the success of the operation and good recovery after the operation. In the past three years, the patient had regular re-examination of chest CT, and there were no signs of tumor recurrence and metastasis; no adjuvant treatment such as chemoradiotherapy, etc., which avoided both the toxic side effects of radiotherapy and the heavy economic burden. The recent curative effect is very good. This case will be followed up for a long time in the hope of obtaining a good long-term outcome. Pleural confined fibrous tumor is a rare (uncommon) thoracic tumor. Its X-ray and CT manifestations lack specificity and are easily confused with pleural encapsulated effusion, tuberculous pleurisy, lung tumor and pleural mesothelioma, pleural metastasis, etc. The principle of treatment for pleural confined fibrous tumor is complete surgical resection, including the tumor and the affected adjacent tissues. The intraoperative and postoperative risks should be fully estimated before surgery, and attention should be paid to exact intraoperative hemostasis and prevention of chest wall bleeding, etc.; to prevent serious cardiopulmonary pathologies caused by pulmonary edema after resection of huge thoracic tumors and mediastinal oscillation after release of mediastinal compression. In this case, the tumor occupied the whole field and adhered to the chest wall through the left posterior lateral incision of V intercostal entry, and the upper and lower posterior ribs were broken; intraoperative and postoperative fluid intake and infusion speed were strictly controlled to prevent the occurrence of recurrent pulmonary edema.