The case of an 83 year-old male patient undergoing resection of a bulky thymoma situated in the anterior mediastinum is presented. A standard mid-line sternotomy approach was chosen and the left pleural space was widely opened in order to control the left edge of the tumor bulging in the left hemithorax. Macroscopic and histologic examination of the resected specimen evidenced a medullary thymoma without infiltration although tight adhesions between the tumor and the left brachiocephalic vein were present. Postoperative course was uneventful and the patient was discharged in good general condition nine days after surgery.