Objective  To summarize and analyze the disease spectrum of testicular and adnexal lesions in Tibetan patients in Tibet Autonomous Region.

  Methods  The relevant data of all Tibetan patients with testicular and adnexal lesions diagnosed by pathology in Tibet Autonomous Region People's Hospital from January 2012 to March 2021 were collected retrospectively, including age, clinical manifestations, general manifestations of diseased tissues, and diagnostic results.

  Results  There were 317 cases of testicular and adnexal lesions diagnosed by pathology, with the mean age of (38.72±19.74) years and the clinical manifestations mainly characterized by swelling and pain in the scrotum area (88.01%, 279/317). There were 85 cases of neoplastic diseases (26.81%, 85/317), in which malignant tumors accounted for 96.47%, with an average age of (38.09±14.52) years. There were 232 cases of non-neoplastic diseases (73.19%, 232/317), with an average age of (38.94±21.36) years. The gross manifestations of the lesions were as follows: the lesions of the neoplastic disease were 2-17 cm in diameter and were nodular or lobulated, the sections were solid or cystic-solid, and bleeding or necrosis could be seen in some areas; the lesions of non-neoplastic diseases were 0.6-8 cm in diameter and were mostly cystic with smooth cystic wall, and some lesions were solid nodules. Among neoplastic diseases, the tumor types were germ cell tumors (88.24%, 75/85), lymphohematopoietic tumors (4.71%, 4/85), mesenchymal tumors (4.71%, 4/85), leyding cell tumor(1.18%, 1/85), and papillary cystadenoma of the epididymis (1.18%, 1/85). Among germ cell tumors, seminoma were mainly type (66.67%, 50/75), followed by mixed germ cell tumor (14.67%, 11/75), embryonal carcinoma (12.00%, 9/75). All 4 cases of lymphohematopoietic tumor were diffuse large B-cell lymphoma. Among non-neoplastic diseases, hydrocele accounted for 56.03% (130/232), followed by inflammatory diseases (31.03%, 72/232) and testicular dysplasia (8.62%, 20/232), testicular torsion/infarction (3.88%, 9/232) and testicular adnexal cyst (0.43%, 1/232) accounted for a lower proportion. Testicular and epididymal tuberculosis (77.78%, 56/72) was the main type of inflammatory diseases.

  Conclusions  Testicular and adnexal lesions in Tibetan people maybe more common among middle-aged people, with a complex and diverse disease spectrum, dominated by non-neoplastic disease. Hydrocele and tuberculosis are the most common non-neoplastic diseases. About 1/4 of the lesions are neoplastic diseases, and germ cell tumors are the dominant type.