Fig. 1

Images of the tumor and vital surgical procedures. a An axial view of chest CT. A huge dumbbell shaped tumor (yellow dashed line) was developing into the right Th11–Th12 intervertebral foramen and approaching the spinal canal (yellow arrowheads). b A posterior view of the tumor on 3D-CT. The right 11th and 12th ribs were involved in the tumor. c Via the posterior microscopic approach, the end of the tumor was identified as reaching the proximity of the dura mater. d The tumor was successfully separated from the dura matter. e Via thoracotomy, the resection line on the vertebra was carefully determined with surgical margin from the tumor end. f En bloc tumor resection