Alternatives to Corticosteroids Azatioprim or Tamoxifen for Retroperitoneal Fibrosis

I’m a doctor from Bulgaria. I have a patient with very active woman with retroperitoneal fibrosis, which is not affected either by Corticosteroids Azatioprim well as Tamoxifen
Suggest my other therapy for this patient

Standard that has shown much statistical success is Corticosteroids to reduce inflammation (perhaps three months which sometimes is sufficient to reduce mass and ureteral constriction. If not follow on with very marked success is either cellcept or imuran. Both need time to be successful.

If there is serious ureteral constriction (requiring ureteral stents) esp if bilateral, then ureterolysis with 100% omental wrap is suggested. Robotic assisted is shortest recovery time.

Thank you
My patient is held all this medication that you mentioned.
It has now been eight years in remission, then again with activity
An operation of the right ureter, free of fibrosis. Currently has two stand of both ureters. Experienced and porter vein thrombosis. Starting Treatment with mycophenolate-mufetil.Could you offer me any other treatment?