We report a case of epithelioid hemangioendothelioma arising from the left brachiocephalic vein in the anterior superior mediastinum of a 41-year-old man. The tumor was resected by local excision using a novel approach, the "hemi-plastron window" technique. The patient had an uneventful postoperative course and no recurrence of tumor 28 months after surgical treatment. We describe this surgical approach and discuss its advantage for cervicothoracic tumors.