A neck mass is a risk factor for difficult airway during induction of anaesthesia particularly when accompanied with a giant back mass which limits positioning of the patient in the supine position. We report the management of a young woman with known recurrent neurofibroma scheduled for resection of her giant neck and back masses. Unfortunately, her dorsal thoracic mass was too huge to allow adoption of the supine position for induction of anaesthesia. In order to achieve a suitable supine position which is fundamental during airway management, we created a hole in the operating table to fit her giant back mass. Exhibition of this special operating table may help to achieve a suitable position and ease airway management which is not possible with routine tables in cases with giant posterior masses.