New Clinical Decision Support Score Based on Steroid Hormone Profiling in the Diagnosis of MACS

Inclusion Criteria: MACS and ANS group: * 18 years ≤ Age * Patient with one or more unilateral or bilateral adrenal nodules with spontaneous density \< 20 HU on CT and major axis ≥ 1 cm and without associated overt pathological hormonal secretion. * Patient with one or more uni or bilateral adrenal nodules not meeting the above density criteria but without malignancy criteria and stable in size on imaging after at least 6 months of follow-up and without associated overt pathological hormone secretion. * Written consent of the patient for his participation in the research (at the latest on the day of inclusion and before any examination required by the research). * Subject affiliated to or benefiting from a social security scheme. Diagnostic criteria (determined after blood sampling) for continuation of the study: MACS group: * At least two elevated DST1mg (Cortisol \> 50 nmol/L or 1.8 µg/dL) AND * a plasma ACTH level ≤ 20 pg/mL ANS group: \- Normal DST1mg (Cortisol ≤ 50 nmol/L or 1.8 µg/dL). The definition criteria for MACS and ANS were based on the latest recommandations of learned societies. Controls group: * patients followed in the endocrinology department, free of any known adrenal pathology and with a DST1mg test \< 50nmol/L. * matched for age and sex to patients in groups 1 and 2. Non -inclusion criteria: * Adrenal incidentaloma \< 1 cm in size. * Use of exogenous corticosteroids, whether systemic or local (inhaled, eye and ear drops, ophthalmic ointment, topical skin products, joint infiltration) in the 6 months prior to the trial, and drugs that interfere with the metabolism of dexamethasone. * Pregnant women. * Patients with any other life-threatening condition. * Patients with an intercurrent pathology at the time of blood sampling (fever, COVID infection, influenza....). * Urinary free cortisol (UFC) \> at the limit of laboratory normality. * Patients under court protection.