Immunosuppressive therapy for idiopathic retroperitoneal fibrosis: a retrospective analysis of 26 cases

Idiopathic retroperitoneal fibrosis is characterized by the extensive development of inflammatory fibrotic tissue in the retroperitoneum, leading to the compression and obstruction of the ureters and other adjacent organs [1], [2] and [3]. Ureterolysis and omental wrapping [4] and [5] do not always prevent the recurrence of ureteral obstruction and are associated with substantial morbidity and occasional mortality [4], [6], [7] and [8]. Periodic ureteral stenting in combination with medical treatment with a variety of agents, including tamoxifen, seems to provide an effective alternative to surgery [1], [6], [7], [9], [10], [11] and [12]. Tamoxifen is thought to be effective because it increases the production of transforming growth factor β, an immunosuppressive cytokine that modulates fibroblast activity