This paper presents our experience on the characterization of cystic pancreatic lesions using CT and MRI. First of all, true cystic pancreatic neoplasms should be differentiated from pseudocysts. Noninvasive characterization of cystic pancreatic neoplasms continues to rely principally on CT and MRI. Despite the presence of classic radiological characteristics of various cystic pancreatic neoplasms, these lesions continue to be problematic for the radiologist. They are most frequently incidental findings that are not related to the reason for imaging the patients in whom they are discovered. The radiological and clinical challenges are to determine the benign or malignant nature of the lesion and its potential resectability. The heterogeneity among cystic lesions and overlap in imaging characteristics should cause radiologists to approach the specific characterization of cystic pancreatic masses with a substantial degree of humility. Recommending an appropriate management approach based on imaging findings, in conjunction with clinical information and clinical consultation, may therefore be more important than attempting to assign a specific diagnosis to a cystic pancreatic lesion.

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