<p>Esophageal carcinoma is very rare in young people, particularly during pregnancy. We present a rare fatal case of esophageal adenocarcinoma in a 26.-year old pregnant woman with the full-term delivery of a healthy baby. Alarming symptoms despite being considered hyperemesis gravidarum raised suspicion of the upper digestive system neoplasia, which was confirmed by subsequent diagnostic work-up, including endoscopy, biopsy, and histopathology. Although the deceased’s family suspected possible medical negligence, it was not proven, but was evaluated and interpreted as an unintended outcome. Namely, the pregnant woman did not want to undergo a diagnostic examination of the digestive system in the 20th week of pregnancy, but almost towards the end of the pregnancy, when a malignant neoplasm of the esophagus was diagnosed. After delivery of health baby, she died two months later. This unfortunate case underscores the necessity of maintaining a high index of suspicion for malignancy in persistent gastrooesophageal symptoms during pregnancy. The refusal of diagnostic and therapeutic procedures by the patient dictated the dissemination of the disease and the fatal outcome, which could not be influenced by the professional malpractice, and therefore certainly has a forensically and clinically interesting discussion.</p>