We reported a long-term survivor with invasive thymoma associated with myasthenia gravis. The patient underwent operations 4 times for these 13 years. At the third and fourth operation, the tumor was resected after preoperative neo-adjuvant chemotherapy with cisplatin and adriamycin, and postoperative radiotherapy was added. Her postoperative course was uneventful, and she has been alive. Our strategy for invasive thymoma is that tumors which include both primary and recurrent lesions are removed as completely as possible, and that postoperative radiotherapy is added for stage II, III and IV in Masaoka's classification, and preoperative neo-adjuvant chemotherapy for stage III and IV. We believe that these multidisciplinary treatments and long term follow-up lead good results without harm to quality of life.