Three advanced or recurrent thyroid carcinomas invading the adjacent surrounding organs such as trachea, great vessels or anterior mediastinum were reviewed. In one patient, resection of subtotal thyroid combined with trachea including a part of cricoid cartilage was performed, and followed with end to end anastomosis. In the other two patients with SVC syndrome, a trans-sternal surgical approach was applied in order to resect a large tumor extending into the anterior mediastinum. Replacement of SVC with ringed PTFE graft and chest wall resection was performed in one patient. With these extended surgical intervention, more operative radicality, prolonged surviving time and better quality of life were expected.