SlideShare a Scribd company logo

Management of Wilms Tumors

•Download as ODP, PDF•
•
Santam Chakraborty
Santam Chakraborty

Multimodality management of Wilms Tumor

Health & MedicineTechnology
1 of 127
Management of Wilms' Tumor Moderator: Dr Sushmita Ghoshal
History ,[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis
Renal Development Metanephric blastema
Nephrogenic Rests ,[object Object],[object Object],[object Object],[object Object]
Wilms Tumorigenesis
Genetics of Wilms Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathology
Histology ,[object Object],[object Object],[object Object],[object Object]
Tumor Components
Special Points ,[object Object],[object Object],[object Object],[object Object],[object Object]
Histology: Anaplastic ,[object Object],[object Object],[object Object],[object Object]
Diffuse Anaplasia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anaplastic Wilms Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features
Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Congenital Anomalies ,[object Object],[object Object]
Congenital Anomalies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WAGR Syndrome Wilms Tumor Aniridia Genitourinary abnormalities Mental Retardation
Denys Drash Syndrome Diffuse Mesangial Sclerosis Male Pseudohermaphorditism Wilms Tumor
Beckwith-Wiedemann Syndrome Microcephaly Umbilical Hernia Ear lobe crease Macroglossia Hemihypertrophy
Workup
Investigations ◄ To establish the diagnosis ◄ Delineate tumor extent ◄ Confirm contralateral renal functional status ◄ Discover any metastasis ◄ Assess fitness for surgery / anaesthesia AIMS
Routine Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Special investigations ,[object Object],[object Object],[object Object],[object Object]
Pediatric Renal Mass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pediatric Renal masses
Staging
Staging: Historical Aspects ►
Stage I ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage II ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage III ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage IV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage V ,[object Object],[object Object],[object Object],[object Object],N.B.: Both systems specify that the tumors should be individually staged.
Overview of the recent system
Treatment History
Radiation Therapy ,[object Object],[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object],[object Object],[object Object]
Roles of Radiotherapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemotherapy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment
Study Groups ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multimodality Management: Why? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management Protocol ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment Outline ,[object Object],[object Object],[object Object]
Neoadjuvant Chemotherapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgery
Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Issues in surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nephrectomy alone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Post nephrectomy management
Stage I ,[object Object],[object Object],[object Object],[object Object],A = Actinomycin D (1.35 mg/m 2 ; max 2.3 mg) V = Vincristine (1.5 mg/m 2 ; max 2.0 mg) V*= Vincristine (2.0 mg/m 2 ; max 2.0 mg)
Stage II ,[object Object],[object Object],[object Object],[object Object],[object Object],A = Actinomycin D (1.35 mg/m 2 ; max 2.3 mg) V = Vincristine (1.5 mg/m 2 ; max 2.0 mg) V*= Vincristine (2.0 mg/m 2 ; max 2.0 mg)
Stage III ,[object Object],[object Object],[object Object],[object Object],A = Actinomycin D (1.35 mg/m 2 ; max 2.3 mg) V = Vincristine (1.5 mg/m 2 ; max 2.0 mg) V*= Vincristine (2.0 mg/m 2 ; max 2.0 mg) D = Doxorubicin (45 mg/m 2 ) D* = Doxorubicin (30 mg/m 2 )
Flank Radiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surface Marking: Anterior Upper pole: Midway between the plane of the lower end of the body of the sternum and the transpyloric plane 5 cm Lower pole: Situated midway between the transpyloric and intertubercular planes 7 cm Hilum is on the transpyloric plane, 5 cm. from the middle line 5 cm
Surface marking: Posterior Medial border 2.5 cm from the midline Lateral border 9.5 cm from the midline Tip of spinous process of T11 Tip of spinous process of L3 Parallelogram of Morris
Flank Radiation: Manual ,[object Object],[object Object],[object Object],[object Object],[object Object]
Flank radiation: Simulator ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Whole Abdomen Radiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WAR Manual Marking ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WAR: Simulator markings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage IV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lung Irradiation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lung Bath: Manual ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lung bath: Simulator marking ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other recommended doses ,[object Object],[object Object],[object Object],[object Object]
Unfavourable Histology ,[object Object],[object Object],[object Object]
Age adjusted doses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rhabdoid Tumors ,[object Object],[object Object],[object Object]
Neoadjuvant Chemotherapy ,[object Object],[object Object],[object Object]
Preoperative Chemotherapy: Merits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preoperative Chemotherapy: Demerits ,[object Object],[object Object],[object Object],[object Object],[object Object]
Radiation Timing ,[object Object],[object Object],[object Object]
Modern day results
Trials in Wilms Tumor
Management Practice NWTSG SIOP S x CCT S x CCT
Why the difference ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP vs NWTS regimens
Time-line of SIOP/NWTS trials SIOP 1 (1971-74) SIOP 2 (1974-76) SIOP 5 (1977-80) SIOP 6 (1980-87) SIOP 9 (1987-93) NWTS 1 (1969-74) NWTS 2 (1974-79) NWTS 3 (1979-85) NWTS 4 (1986-94) NWTS 5 (1995-03) SIOP 93-01 (1993-99)
NWTS 1 (1969-74) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NWTS 1 Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 1 (1971-74) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 1 results ,[object Object],[object Object],[object Object]
NWTS 2 (1974-79) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NWTS 2
NWTS 2 results ,[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 2 (1974-76) ,[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 5 (1977-80) ,[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 5 results ,[object Object],[object Object],[object Object],[object Object]
NWTS 3 (1979-85) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NWTS 3
NWTS 3 Results ,[object Object],[object Object],[object Object],[object Object]
SIOP 6 (1980-87) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 6 results ,[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 9 (1987-93) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 9 results ,[object Object],[object Object],[object Object],[object Object],[object Object]
NWTS 4 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NWTS 4
NWTS 4
NWTS 5 results ,[object Object],[object Object],[object Object],[object Object],[object Object]
SIOP 93-01/GPOH ,[object Object],[object Object],[object Object],[object Object],[object Object]
NWTS 5 ,[object Object],[object Object],[object Object],[object Object]
UKW-3 trial ,[object Object],[object Object],[object Object],[object Object],Preoperative Chemotherapy* Immediate Surgery Delayed Surgery after 6 weeks Protocol specific Adjuvant Therapy Vincristine: 1.5 mg/m 2 weekly ActinomycinD: 1.5mg/m 2 * Preoperative Adriamycin in doses of 30mg/m 2 x 3 weekly was given in event of pre-op unfavorable histology V V V V V V A A
Adjuvant Therapy
Results: Pretreatment Biopsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results: Down-staging ,[object Object],[object Object],[object Object],[object Object],[object Object]
Results: Surgical Aspects ,[object Object],[object Object],[object Object],[object Object]
Impact of the trial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Wilms Tumor in special situations
Relapsed / Refractory WT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Relapsed / Refractory WT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RT for Recurrent Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bilateral Wilms Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Initial open biopsy / Trucut biopsy and staging Downstaging with Chemotherapy Bench Surgery* Partial nephrectomy
Wilms Tumor in Adults ,[object Object],[object Object],[object Object],[object Object]
Wilms Tumor in Horseshoe Kidneys ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Follow up and Toxicity
Treatment toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Follow up Protocol
Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thank You

Recommended

Radiation therapy in wilms tumour
Radiation therapy in wilms tumourRadiation therapy in wilms tumour
Radiation therapy in wilms tumour
Kidwai Memorial Institute of Oncology, Bangalore
 
testicular tumors
testicular tumorstesticular tumors
testicular tumors
DrAyush Garg
 
Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...
Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...
Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...
Dr Vishnu A
 
Management of Rectal Cancer
Management of Rectal CancerManagement of Rectal Cancer
Management of Rectal Cancer
Subhash Thakur
 
sacrococcygeal teratoma
sacrococcygeal teratomasacrococcygeal teratoma
sacrococcygeal teratoma
motaip
 
Diagnosis, Treatment & Management of Medulloblastoma
Diagnosis, Treatment & Management of Medulloblastoma Diagnosis, Treatment & Management of Medulloblastoma
Diagnosis, Treatment & Management of Medulloblastoma
Dr Vandana Singh Kushwaha
 
MANAGEMENT OF HEPATOCELLULAR CARCINOMA
MANAGEMENT OF HEPATOCELLULAR CARCINOMAMANAGEMENT OF HEPATOCELLULAR CARCINOMA
MANAGEMENT OF HEPATOCELLULAR CARCINOMA
Isha Jaiswal
 
Neuroblastoma
NeuroblastomaNeuroblastoma
Neuroblastoma
Animesh Agrawal
 

Recommended

Radiation therapy in wilms tumour
Radiation therapy in wilms tumourRadiation therapy in wilms tumour
Radiation therapy in wilms tumour
Kidwai Memorial Institute of Oncology, Bangalore
 
testicular tumors
testicular tumorstesticular tumors
testicular tumors
DrAyush Garg
 
Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...
Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...
Wilm's tumour - The most common kidney tumor in children - Dr Vishnu A [VCR],...
Dr Vishnu A
 
Management of Rectal Cancer
Management of Rectal CancerManagement of Rectal Cancer
Management of Rectal Cancer
Subhash Thakur
 
sacrococcygeal teratoma
sacrococcygeal teratomasacrococcygeal teratoma
sacrococcygeal teratoma
motaip
 
Diagnosis, Treatment & Management of Medulloblastoma
Diagnosis, Treatment & Management of Medulloblastoma Diagnosis, Treatment & Management of Medulloblastoma
Diagnosis, Treatment & Management of Medulloblastoma
Dr Vandana Singh Kushwaha
 
MANAGEMENT OF HEPATOCELLULAR CARCINOMA
MANAGEMENT OF HEPATOCELLULAR CARCINOMAMANAGEMENT OF HEPATOCELLULAR CARCINOMA
MANAGEMENT OF HEPATOCELLULAR CARCINOMA
Isha Jaiswal
 
Neuroblastoma
NeuroblastomaNeuroblastoma
Neuroblastoma
Animesh Agrawal
 
Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
Swarnita Sahu
 
Management of testicular cancers
Management of testicular cancersManagement of testicular cancers
Management of testicular cancers
Narayan Adhikari
 
Sentinel lymph node breast ca
Sentinel lymph node breast caSentinel lymph node breast ca
Sentinel lymph node breast ca
Pannaga Kumar
 
Rhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatment
Rhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatmentRhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatment
Rhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatment
Lazoi Lifecare Private Limited
 
management of early breast cancer
management of early breast cancermanagement of early breast cancer
management of early breast cancer
Ruchir Bhandari
 
Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
vrinda singla
 
Wilm's tumor
Wilm's tumorWilm's tumor
Wilm's tumor
Mohammed Fathy
 
Hormonal therapy in breast cancer
Hormonal therapy in breast cancerHormonal therapy in breast cancer
Hormonal therapy in breast cancer
DrAyush Garg
 
TESTICULAR CANCERS
TESTICULAR CANCERSTESTICULAR CANCERS
TESTICULAR CANCERS
Isha Jaiswal
 
Rhabdomyosarcoma
RhabdomyosarcomaRhabdomyosarcoma
Rhabdomyosarcoma
damuluri ramu
 
Neuroblastoma
NeuroblastomaNeuroblastoma
Neuroblastoma
Ranjeet Patil
 
CA ENDOMETRIUM-KIRAN.pptx
CA ENDOMETRIUM-KIRAN.pptxCA ENDOMETRIUM-KIRAN.pptx
CA ENDOMETRIUM-KIRAN.pptx
Kiran Ramakrishna
 
Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
GAURAV NAHAR
 
Neuroblastoma
NeuroblastomaNeuroblastoma
Neuroblastoma
Sreekanth Nallam
 
Cervix External Beam Radiotherapy techniques
Cervix External Beam Radiotherapy techniquesCervix External Beam Radiotherapy techniques
Cervix External Beam Radiotherapy techniques
Animesh Agrawal
 
Treatment of breast cancer
Treatment of breast cancerTreatment of breast cancer
Treatment of breast cancer
Animesh Agrawal
 
Neuroendocrine Tumors in 2019
Neuroendocrine Tumors in 2019Neuroendocrine Tumors in 2019
Neuroendocrine Tumors in 2019
Mohamed Abdulla
 
Adrenocortical carcinoma --short review
Adrenocortical carcinoma --short reviewAdrenocortical carcinoma --short review
Adrenocortical carcinoma --short review
Ravi7209
 
Testicular tumours
Testicular tumoursTesticular tumours
Testicular tumours
Shubham Lavania
 
Soft tissue sarcomas
Soft tissue sarcomasSoft tissue sarcomas
Soft tissue sarcomas
ReggieL1
 
Wilm tumor and RT management
Wilm tumor and RT managementWilm tumor and RT management
Wilm tumor and RT management
amitabh pandagle
 
Nephroblastoma
NephroblastomaNephroblastoma
Nephroblastoma
KETAN VAGHOLKAR
 

More Related Content

What's hot

What's hot (20)

Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
 
Management of testicular cancers
Management of testicular cancersManagement of testicular cancers
Management of testicular cancers
 
Sentinel lymph node breast ca
Sentinel lymph node breast caSentinel lymph node breast ca
Sentinel lymph node breast ca
 
Rhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatment
Rhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatmentRhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatment
Rhabdomyosarcoma (RMS): Information on symptoms, diagnosis and treatment
 
management of early breast cancer
management of early breast cancermanagement of early breast cancer
management of early breast cancer
 
Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
 
Wilm's tumor
Wilm's tumorWilm's tumor
Wilm's tumor
 
Hormonal therapy in breast cancer
Hormonal therapy in breast cancerHormonal therapy in breast cancer
Hormonal therapy in breast cancer
 
TESTICULAR CANCERS
TESTICULAR CANCERSTESTICULAR CANCERS
TESTICULAR CANCERS
 
Rhabdomyosarcoma
RhabdomyosarcomaRhabdomyosarcoma
Rhabdomyosarcoma
 
Neuroblastoma
NeuroblastomaNeuroblastoma
Neuroblastoma
 
CA ENDOMETRIUM-KIRAN.pptx
CA ENDOMETRIUM-KIRAN.pptxCA ENDOMETRIUM-KIRAN.pptx
CA ENDOMETRIUM-KIRAN.pptx
 
Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
 
Neuroblastoma
NeuroblastomaNeuroblastoma
Neuroblastoma
 
Cervix External Beam Radiotherapy techniques
Cervix External Beam Radiotherapy techniquesCervix External Beam Radiotherapy techniques
Cervix External Beam Radiotherapy techniques
 
Treatment of breast cancer
Treatment of breast cancerTreatment of breast cancer
Treatment of breast cancer
 
Neuroendocrine Tumors in 2019
Neuroendocrine Tumors in 2019Neuroendocrine Tumors in 2019
Neuroendocrine Tumors in 2019
 
Adrenocortical carcinoma --short review
Adrenocortical carcinoma --short reviewAdrenocortical carcinoma --short review
Adrenocortical carcinoma --short review
 
Testicular tumours
Testicular tumoursTesticular tumours
Testicular tumours
 
Soft tissue sarcomas
Soft tissue sarcomasSoft tissue sarcomas
Soft tissue sarcomas
 

Viewers also liked

Wilm tumor and RT management
Wilm tumor and RT managementWilm tumor and RT management
Wilm tumor and RT management
amitabh pandagle
 
2nd sem prelim slides
2nd sem prelim slides2nd sem prelim slides
2nd sem prelim slides
Dee Tabita
 
Chapter 9 powerpoint presentation slide
Chapter 9 powerpoint presentation slideChapter 9 powerpoint presentation slide
Chapter 9 powerpoint presentation slide
holman83
 

Viewers also liked (11)

Wilm tumor and RT management
Wilm tumor and RT managementWilm tumor and RT management
Wilm tumor and RT management
 
Nephroblastoma
NephroblastomaNephroblastoma
Nephroblastoma
 
Management of renal cell carcinoma and wilms' tumor
Management of renal cell carcinoma and wilms' tumor Management of renal cell carcinoma and wilms' tumor
Management of renal cell carcinoma and wilms' tumor
 
Nephroblastoma
NephroblastomaNephroblastoma
Nephroblastoma
 
2nd sem prelim slides
2nd sem prelim slides2nd sem prelim slides
2nd sem prelim slides
 
Wilms tumor
Wilms tumorWilms tumor
Wilms tumor
 
Wilms' Tumor
Wilms' TumorWilms' Tumor
Wilms' Tumor
 
Wilm’s Tumor
Wilm’s TumorWilm’s Tumor
Wilm’s Tumor
 
Chapter 9 powerpoint presentation slide
Chapter 9 powerpoint presentation slideChapter 9 powerpoint presentation slide
Chapter 9 powerpoint presentation slide
 
Wilm’s tumor
Wilm’s tumorWilm’s tumor
Wilm’s tumor
 
Wilms tumor and neuroblastoma
Wilms tumor and neuroblastomaWilms tumor and neuroblastoma
Wilms tumor and neuroblastoma
 

Similar to Management of Wilms Tumors

Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...
Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...
Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...
European School of Oncology
 
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
European School of Oncology
 
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
European School of Oncology
 
Carcinoma thyroid final
Carcinoma thyroid finalCarcinoma thyroid final
Carcinoma thyroid final
Zahoor Khan
 
Carcinoma Thyroid Final
Carcinoma Thyroid FinalCarcinoma Thyroid Final
Carcinoma Thyroid Final
Zahoor Khan
 

Similar to Management of Wilms Tumors (20)

Surgical Oncology
Surgical OncologySurgical Oncology
Surgical Oncology
 
Testicular Cancer
Testicular CancerTesticular Cancer
Testicular Cancer
 
Ovariancancer chandni
Ovariancancer chandniOvariancancer chandni
Ovariancancer chandni
 
Endometrium part 1 2018
Endometrium part 1 2018Endometrium part 1 2018
Endometrium part 1 2018
 
Cervical cancer
Cervical cancerCervical cancer
Cervical cancer
 
Prostrate cancer
Prostrate cancerProstrate cancer
Prostrate cancer
 
1080823-常見的大腸疾病
1080823-常見的大腸疾病1080823-常見的大腸疾病
1080823-常見的大腸疾病
 
Secondary tumours of ovary
Secondary tumours of ovarySecondary tumours of ovary
Secondary tumours of ovary
 
Tumors
TumorsTumors
Tumors
 
Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...
Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...
Rare Solid Cancers: An Introduction - Slide 10 - V. Kataja - Rare urological ...
 
5. Cellular Aberration
5. Cellular Aberration 5. Cellular Aberration
5. Cellular Aberration
 
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
 
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
Rare Solid Cancers: An Introduction - Slide 8 - I. Ray-Coquard - Rare female ...
 
Colo-rectal Carcinoma at a glance !!!
Colo-rectal Carcinoma at a glance !!!Colo-rectal Carcinoma at a glance !!!
Colo-rectal Carcinoma at a glance !!!
 
Carcinoma thyroid final
Carcinoma thyroid finalCarcinoma thyroid final
Carcinoma thyroid final
 
Carcinoma Thyroid Final
Carcinoma Thyroid FinalCarcinoma Thyroid Final
Carcinoma Thyroid Final
 
Malignant disorders
Malignant disorders Malignant disorders
Malignant disorders
 
Tumor
TumorTumor
Tumor
 
testicular tumor
testicular tumortesticular tumor
testicular tumor
 
16.UTERINE DISORDERS (B.M.A).pptx
16.UTERINE DISORDERS (B.M.A).pptx16.UTERINE DISORDERS (B.M.A).pptx
16.UTERINE DISORDERS (B.M.A).pptx
 

More from Santam Chakraborty

Evolving Role of Radiation Therapy in Hodgkins Disease
Evolving Role of Radiation Therapy in Hodgkins DiseaseEvolving Role of Radiation Therapy in Hodgkins Disease
Evolving Role of Radiation Therapy in Hodgkins Disease
Santam Chakraborty
 
Isocentre How to Create a Page
Isocentre How to Create a PageIsocentre How to Create a Page
Isocentre How to Create a Page
Santam Chakraborty
 

More from Santam Chakraborty (20)

Adjuvant radiation based on genomic risk factors emerging scenarios
Adjuvant radiation based on genomic risk factors emerging scenariosAdjuvant radiation based on genomic risk factors emerging scenarios
Adjuvant radiation based on genomic risk factors emerging scenarios
 
Sample size calculation
Sample size calculationSample size calculation
Sample size calculation
 
IGRT in lung cancer
IGRT in lung cancerIGRT in lung cancer
IGRT in lung cancer
 
Refresher in statistics and analysis skill
Refresher in statistics and analysis skillRefresher in statistics and analysis skill
Refresher in statistics and analysis skill
 
Induction chemotherapy followed by concurrent ct rt versus ct-rt in advanced ...
Induction chemotherapy followed by concurrent ct rt versus ct-rt in advanced ...Induction chemotherapy followed by concurrent ct rt versus ct-rt in advanced ...
Induction chemotherapy followed by concurrent ct rt versus ct-rt in advanced ...
 
To use or not to use the LQ model at “high” radiation doses
To use or not to use the LQ model at “high” radiation doses To use or not to use the LQ model at “high” radiation doses
To use or not to use the LQ model at “high” radiation doses
 
LDR and HDR Brachytherapy: A Primer for non radiation oncologists
LDR and HDR Brachytherapy: A Primer for non radiation oncologistsLDR and HDR Brachytherapy: A Primer for non radiation oncologists
LDR and HDR Brachytherapy: A Primer for non radiation oncologists
 
Introduction to meta analysis
Introduction to meta analysisIntroduction to meta analysis
Introduction to meta analysis
 
Concurrent Chemoradiation in Postoperative Setting In LAHNC. A comparision of...
Concurrent Chemoradiation in Postoperative Setting In LAHNC. A comparision of...Concurrent Chemoradiation in Postoperative Setting In LAHNC. A comparision of...
Concurrent Chemoradiation in Postoperative Setting In LAHNC. A comparision of...
 
Evolving Role of Radiation Therapy in Hodgkins Disease
Evolving Role of Radiation Therapy in Hodgkins DiseaseEvolving Role of Radiation Therapy in Hodgkins Disease
Evolving Role of Radiation Therapy in Hodgkins Disease
 
Hormone Resistant Prostate Cancer
Hormone Resistant Prostate CancerHormone Resistant Prostate Cancer
Hormone Resistant Prostate Cancer
 
How to upload presentation
How to upload presentationHow to upload presentation
How to upload presentation
 
How to register at Isocentre
How to register at IsocentreHow to register at Isocentre
How to register at Isocentre
 
Isocentre Help Forum
Isocentre Help ForumIsocentre Help Forum
Isocentre Help Forum
 
Isocentre Help Forum
Isocentre Help ForumIsocentre Help Forum
Isocentre Help Forum
 
Isocentre Help Edit Page
Isocentre Help Edit PageIsocentre Help Edit Page
Isocentre Help Edit Page
 
Isocentre How to Create a Page
Isocentre How to Create a PageIsocentre How to Create a Page
Isocentre How to Create a Page
 
Helical Tomotherapy
Helical TomotherapyHelical Tomotherapy
Helical Tomotherapy
 
New Techniques in Radiotherapy
New Techniques in RadiotherapyNew Techniques in Radiotherapy
New Techniques in Radiotherapy
 
IMRT and 3D CRT in cervical Cancers
IMRT and 3D CRT in cervical CancersIMRT and 3D CRT in cervical Cancers
IMRT and 3D CRT in cervical Cancers
 

Recently uploaded

Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
parulsinha
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
parulsinha
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Call Girls Delhi
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Dipal Arora
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
chandars293
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Namrata Singh
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
parulsinha
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
Arohi Goyal
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
GENUINE ESCORT AGENCY
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
karishmasinghjnh
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Inaaya Sharma
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Sheetaleventcompany
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
adilkhan87451
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
GENUINE ESCORT AGENCY
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Dipal Arora
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Sheetaleventcompany
 

Recently uploaded (20)

Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
 

Management of Wilms Tumors