Solitary fibrous tumors of the pleura (SFTPs) are rare spindle cell neoplasms. The standard treatment is complete resection, but this may be challenging if the tumor is extremely large and originates from the diaphragm. We experienced a case of a giant solitary fibrous tumor originating from the diaphragm. A 74-year-old man presented with an asymptomatic giant mass on the right diaphragm suspicious of a solitary fibrous tumor. We performed a subcostal incision following posterolateral thoracotomy for complete resection. This surgical approach provided a better field around the diaphragm and facilitated radical and safe complete en bloc resection. The pathological diagnosis was a malignant solitary fibrous tumor. The patient survived for 1 year postoperatively without recurrence. We conclude that extended thoracotomy combined with a subcostal incision is a useful approach for surgical removal of giant tumors of the diaphragm.
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