Abstract:This case was a recurrent giant dumbbell-shaped schwannoma in an elderly patient whose tumor invaded the upper thoracic intervertebral foramen of the posterior mediastinum. For the patient's first operation, the tumor in the spinal canal and intervertebral foramen was excised to relieve the spinal cord compression and promote the recovery of the nerve function. 44 months after the first operation, the patient's symptoms recurred. The tumor in the posterior mediastinum recurred in a short time, and it increased significantly compared with the previous time. We performed a second operation under general anesthesia: posterior thoracic schwannoma resection + pedicle screw fixation + T2 vertebral body debridement + bone graft fusion. The tumor was completely removed and the spinal stability was reconstructed by the operation, and the curative effect was good. Based on the experience of this case, complete tumor resection through the posterior median approach may be a safe operation for some of the giant dumbbell-shaped schwannomas in the posterior mediastinum.