The MRI features are most consistent with female pseudohermaphroditism due to congenital adrenal hyperplasia (CAH). In this case, the karyotype was 46 XX.

The causes of female pseudohermaphroditism include congenital adrenal hyperplasia which is the most common, transplacental androgen exposure, and XX male syndrome.

The presence of prostate tissue in female pseudohermaphroditism is rarely described in the literature ^1,2.