Neurogenic tumors of the posterior mediastinum commonly constitute an extraspinal portion of a dumb-bell tumor affecting the spinal canal. In a 42-year-old man with a history of back pain for more than 6 months and severe lower-limb paralysis and impaired urinary voiding for 20 days, chest radiography showed a posterior mediastinal mass and thoracic myelogram a total extradural defect at the level of T10. A computed tomography scan showed extension of this intrathoracic mass into the intraspinal space through the spinal foramen. In a single-stage operation, posterolateral thoracotomy and laminectomy were performed. This surgical approach avoids complications, notably from traction on the spinal cord.