A case of giant cell tumor involving the Th4 vertebral body is reported. A 27-year-old man, who had a 2 month history of back pain and paraparesis, was admitted to our department in August, 1986. On the first admission, he manifested severe paraparesis and sensory disturbance below the Th5 dermatome level. Neuroradiological examination demonstrated an epidural tumor involving the Th4 vertebral body and compressing the spinal cord. Emergency laminectomy for decompression and biopsy was performed. The surgical specimen was a giant-cell tumor. 6 weeks after the first operation, total removal of the tumor and anterior fusion of the Th 3-5 with iliac bone graft was performed through the anterolateral transthoracic approach. Postoperative course was uneventful. A curative resection and immediate stabilization was thus able to be undertaken through the anterolateral transthoracic approach, when the epidural tumor was confined to the thoracic vertebral body.