A young adult male with precursor B-cell acute lymphoblastic leukemia was admitted with febrile neutropaenia following standard BFM consolidation (Phase II) on the United Kingdom Acute Lymphoblastic Leukaemia 2003 (UKALL2003) Regimen B protocol. An infected pilonidal sinus was diagnosed and treated with incision, drainage and broad spectrum antibiotics. Post-operatively he complained of a sore throat and cough. High-resolution computed tomography demonstrated a hypodense soft tissue mass indenting the trachea in the subglottic region (upper panel; indicated by arrow). © 2012 John Wiley & Sons A/S.