Under what circumstances would you refer a patient with mild autonomous cortisol secretion without features of Cushing syndrome for adrenalectomy?  

This depends on a number of factors, including the number and severity of comorbidities, the degree of abnormality in the 1 mg DST, and other biochemical testing, such as ACTH and DHEAS levels. The age of the patient may also have some impact on decision making being more aggressive in younger patie...