Malignant transformation
A "benign" grade 0 (mature) teratoma nonetheless has a risk of malignancy. Recurrence with malignant endodermal sinus tumor has been reported in cases of formerly benign mature teratoma, even in fetiform teratoma and fetus in fetu. Squamous cell carcinoma has been found in a mature cystic teratoma at the time of initial surgery. A grade 1 immature teratoma that appears to be benign (e.g., because AFP is not elevated) has a much higher risk of malignancy, and requires adequate follow-up. This grade of teratoma also may be difficult to diagnose correctly. It can be confused with other small round cell neoplasms such as neuroblastoma, small cell carcinoma of hypercalcemic type, primitive neuroectodermal tumor, Wilms tumor, desmoplastic small round cell tumor, and non-Hodgkin lymphoma.A teratoma with malignant transformation  is a very rare form of teratoma that may contain elements of somatic malignant tumors such as leukemia, carcinoma, or sarcoma. Of 641 children with pure teratoma, nine developed TMT: five carcinoma, two glioma, and two embryonal carcinoma (here, these last are classified among germ cell tumors). Extraspinal ependymoma
Extraspinal ependymoma, usually considered to be a glioma (a type of nongerm cell tumor), may be an unusual form of mature teratoma. Treatment
Surgery
The treatment of choice is complete surgical removal (i.e., complete resection). Teratomas are normally well-encapsulated and noninvasive of surrounding tissues, hence they are relatively easy to resect from surrounding tissues. Exceptions include teratomas in the brain, and very large, complex teratomas that have pushed into and become interlaced with adjacent muscles and other structures.
Among the forms of spastic CP, quad CP is more likely to co-occur with seizures and mild to moderate intellectual disability.In spastic cerebral palsy in children with low birth weights, 25% of children had hemiplegia, 37.5% had quadriplegia, and 37.5% had diplegia. No one person with a particular type of spastic CP presents in exactly the same way. Treatment
There is no cure for spastic cerebral palsy and no way to reverse the initial brain injury. However, various treatments and assistive devices can help mitigate pain and allow those affected to have a higher quality of life. Different combinations of treatments are right for each individual and are determined by individuals and their care team.Some common interventions are:

Physical therapy- exercises to develop balance and strength and to learn skills such as walking, rolling, or driving a wheelchair. Occupational therapy- therapy to help an individual develop strategies to complete activities of daily living such as dressing, toileting, and bathing either independently or with a level of assistance that is safe and comfortable. Orthotics- braces and splints to improve posture and positioning (usually on legs or arms). Assistive devices- Wheelchairs, crutches, and walkers may help someone with spastic CP navigate safely. Different devices may be used in different settings or for longer distances. People with cerebral palsy may use up to 3-5 times the energy as those without when moving; thus, a device such as a wheelchair may reduce fatigue.