Cinacalcet reduces serum calcium but is not tolerated by many patients. Cinacalcet does not provide symptom relief of PHPT and more commonly increases subjective symptoms. Prolonged use is associated with continued bone loss in some patients, possibly due to persistent elevated PTH levels. With very few exceptions, pHPT can be cured via a quick outpatient operation, which remains the treatment of choice.
The incidence of true iT-PA is less than 1%, occurring in predictable locations. Thyroid lobectomy for a missing parathyroid adenoma is typically unsuccessful and should only rarely, if ever, be performed.
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