Primary pancreatic lesions may present with unusual features ranging from cystic change in ductal adenocarcinoma and islet cell tumors to ductal communication in solid pseudopapillary and mucinous tumors. Consideration of unusual variations of primary pancreatic neoplasm in the differential diagnosis of solid and cystic pancreatic lesions is necessary for their proper diagnostic work-up and management. We present the rare imaging manifestations and corresponding pathologic correlation of a representative group of primary pancreatic tumors, including pancreatic adenocarcinoma, islet cell tumor, solid pseudopapillary tumor, and serous/mucinous cystic tumors.