Neurosarcoma is relatively rare, but is seen frequently in association with stigmata of neurofibromatosis ie., Cafe au lait pigmentation and cutaneous neurofibromatosis. Both advanced age and association with neurofibromatosis increase the likelihood of malignant degeneration to neurosarcoma. It also may be dumb bell-shaped with intraspinal extension. Thoracic meningocele is rare and represents a protrusion of the dural sac through an abnormally large or malformed intervertebral foramen. The patient is usually asymptomatic, with evidence of paravertebral mass on the chest rentgenogram. In one operation we removed a "Dumb-bell" neurosarcoma and intrathoracic meningocele in a 52 year old woman using a cervical laminectomy with a trap-door incision. She was discharged at 17 days after the operation with a sequelae of excision of nerve roots C8 and T1. Postoperative radiation therapy was performed during the follow-up period.up period.