Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: headaches x5 days, clumsiness in his l-arm major surgical or invasive procedure: : r parietal craniotomy for metastic lesion history of present illness: the patient is a 46 yo r-handed man with a history of htn who presents to the ed with a 5 day history of headaches, clumsiness in his l-arm and walking into objects on the l. the pt was in his usoh until last saturday (), when he noted that when he tried to grasp his t-shirt with his l-arm, this arm "wasn't doing it properly". he says he could feel well and that the arm didn't feel weak, but that his arm didn't exactly do what he wanted it to do. he continued to drop items, especially small ones, during the rest of the week. no numbness or tingling. at the time he first noted the clumsiness, he also felt lightheaded. a few after the first event, he noted a headache, bifrontal, squeezing. the headache is not affected by position, light makes it worse. it has been associated with nausea, but no vomiting. no nightly awakenings. typically, during the rest of the week, the headaches would last about 30 min. at baseline he never has any headaches like these; no migraines. in addition, he has noted that he has been walking into doorposts/objects at the left side only. he has not noted any problems with his vision. he attributed this to problems in his leg. finally, he has been getting more forgetful, which is unusual for him. he contact his pcp with the above story, who refered him to the ed. he is accompanied by a good friend. ros: denies any fever, chills,visual changes, hearing changes, neckpain/backpain, vomiting, dysphagia, weakness, tingling, numbness, bowel-bladder dysfunction, chest pain, shortness of breath, abdominal pain, dysuria, hematuria, or bright red blood per rectum. weightloss 5pounds over the last months, no intention. past medical history: -hypertension since yrs -l-inguinal hernia, s/p surgery social history: occupation: works as a dj as well as in a digital photolab smoking: no, but has been exposed to second hand smoke (as a dj); ethoh: 6pack on fridays; drug abuse: no. single, takes care of mom; has had one unsafe sexual relationship family history: -positive for dm and htn; sister has seizures since childhood; no cancers; no migraines physical exam: vitals: t99.4 hr108 bp173/74 rr16 so2 100% gen: nad heent: mmm, anicteric neck: no lad; no carotid bruits; full range neck movements lungs: clear to auscultation bilaterally heart: regular rate and rhythm, normal s1 and s2, ii/vi murmur, gallops and rubs. abdomen: normal bowel sounds, soft, nontender, nondistended extremities: no clubbing, cyanosis, ecchymosis, or edema mental status: awake and alert, cooperative with exam, normal affect. oriented to place, month, day, and date (although it takes him a while to come up with , first says ), person. attention: moybw: gets into trouble - (keeps reversing), finally makes it to : registration: items; recall at 5 min. language: fluent; repetition: intact; naming intact, including colors; comprehension intact; no dysarthria, no paraphasic errors. writing: intact. : intact; prosody: normal. fund of knowledge normal; no apraxia. no neglect. cranial nerves: ii: visual acquity intact. visual fields: l-upperquadrantanopia, pupils equally round and reactive to light both directly and consensually, 2-->1 mm bilaterally. disc margins sharp, no pappilledema. iii, iv, vi: extraocular movements intact without nystagmus. fixation and saccades are normal. no ptosis. v: facial sensation intact to light touch and pinprick. vii: facial movement symmetrical; no facial droop. viii: hearing intact to finger rub bilaterally. ix: palate elevates in midline. xii: tongue protrudes in midline, no fasciculations. : sternocleidomastoid and trapezius normal bilaterally. motor system: normal bulk and tone bilaterally. no adventitious movements, no tremor, no asterixis. strength is full. no pronator drift, but a clear parietal drift on the l. no rebound. sensory system: sensation intact to light touch, pin prick, temperature (cold), vibration, and proprioception in all extremities. agraphestesia in both hands; proposagnosia on the l-arm reflexes: b t br pa pl right 2 2 2 2 2 left 3 3 3 3 3 (few beats clonus in ankle; crossed adductor) toes: mute bilaterally. coordination: normal , , hts. no dysmetria or pastpointing. gait: narrow based, normal arm swing, normal initiation. romberg: negative. able to do tandem gait, walk on toes, walk on heels. pertinent results: 01:00am blood wbc-7.3 rbc-4.30* hgb-9.4* hct-29.4* mcv-68* mch-21.8* mchc-31.8 rdw-15.4 plt ct-436 01:00am blood neuts-75.5* lymphs-18.3 monos-4.9 eos-0.6 baso-0.7 07:10am blood wbc-6.2 rbc-4.88 hgb-11.4* hct-35.5* mcv-73* mch-23.3* mchc-32.0 rdw-16.5* plt ct-302 01:00am blood pt-13.9* ptt-26.5 inr(pt)-1.2* 01:00am blood glucose-122* urean-15 creat-1.4* na-138 k-5.1 cl-97 hco3-26 angap-20 07:10am blood glucose-98 urean-13 creat-0.9 na-145 k-3.5 cl-102 hco3-30 angap-17 10:35am blood alt-34 ast-27 ld(ldh)-244 alkphos-92 amylase-50 totbili-0.3 10:35am blood lipase-24 10:35am blood albumin-3.7 calcium-9.5 phos-4.4 mg-1.9 09:20am blood phenyto-10.6 ----- head ct :impression: 1.4-cm round mass lesion with peripheral hemorrhage and surrounding extensive vasogenic edema. there is minimal subfalcine herniation without evidence of transtentorial or uncal herniation. ----- head ct :impression: post-operative appearance to the brain without evidence of transtentorial or uncal herniation, and with minimal leftward subfalcine herniation, that was also present on the prior study. ----- head mr 4/21:1. 1.8-cm enhancing mass in the right frontoparietal lesion with hemorrhagic component, with edema that partially enters into right side of the splenium of corpus callosum, corresponding to the finding on ct scan. the finding is most likely representing metastatic disease; however, other differential diagnoses include lymphoma and pnet. 2. normal mr angiography. ----- brain pathology: metastatic clear cell carcinoma most consistent with metastatic renal cell carcinoma. ----- mri post-op:impression: status post resection of right parietal enhancing lesion. blood products are seen at the surgical site with a small area of residual enhancement suspected at the anterior margin of the surgical cavity. surrounding edema is again noted, unchanged. no interval new abnormalities are seen. ----- ct torso:large, heterogeneously-enhancing, necrotic left renal neoplasm, likely renal cell carcinoma. pulmonary metastases as well as a single probable hepatic metastasis are seen. filling defect within the left renal vein may represent non- occlusive bland or tumor thrombus. brief hospital course: 46 yo r-handed man with a history of htn who presented to the ed with a 5 day history of headaches, clumsiness in his l-arm, and walking into objects on the left. these symptoms had been fluctuating since onset. on exam, he was very mildly inattentive, had a l-upper quadrantanopia, a l-parietal drift, and agraphesthesia in the l-arm. ct head in the ed showed a round mass in the r-parietal region (/white junction) with extensive edema. in addition, he had anemia. an mri with contrast was ordered which showed the mass in more detail. it was radiographically consistent with a metastasis. he was started on decadron 4 mg q6h due to the edema. he was then taken to surgery for tumor resection. this went well without complication. his exam remained essentially unchanged afterwards. his decadron was slowly weaned after surgery. the preliminary path was renal cell carcinoma. he then had a torso ct which showed a large 11.1 x 18.3 x 13.1 cm renal mass on the left. this did not compress any major vessels. it also showed evidence of bilateral lung metastases and probable liver metastases. the oncology service was consulted and saw him here. they arranged for him to follow-up quickly as an outpatient. he will also follow-up in brain tumor clinic. the treatment course is not fully clear at this time and will be determined at his outpatient oncology appointments. he was seen by social work here for assistance with coping and his new cancer diagnosis. he is clearly upset, but does accept the diagnosis. for seizure prophylaxis, he was started on keppra 500 mg . he will continue this and may need to increase it as an outpatient. he will see multiple neurologists in the near future and this can be managed as well. his dexamethasone will continue at 2 mg for now. again, this may be decreased in the future depending on how he does as an outpatient. cv: continued atenolol, but his creatinine was initially , we stopped his hctz. he will follow-up in brain tumor clinic and with oncology. medications on admission: 1. atenolol 37.5 mg p.o. daily. 2. hydrochlorothiazide 25 mg p.o. daily. discharge medications: 1. atenolol 25 mg tablet sig: 1.5 tablets po daily (daily). disp:*30 tablet(s)* refills:*2* 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. disp:*60 tablet(s)* refills:*2* 3. dexamethasone 2 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 4. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: metastatic renal cell carcinoma s/p resection of brain met discharge condition: neurologically stable discharge instructions: please continue to work with physical therapy to improve your mobility and attend all out patient appointments. followup instructions: please follow-up with dr. heme/oncologist in 1 week from discharge. please call ( to schedule an appointment. dr. referred you to his office. also follow-up with dr. on at 3pm, call for directions to the brain clinic. provider: , md phone: date/time: 4:00 md, procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain transfusion of packed cells other immobilization, pressure, and attention to wound other diagnostic procedures on lymphatic structures diagnoses: malignant neoplasm of liver, secondary unspecified essential hypertension iron deficiency anemia secondary to blood loss (chronic) malignant neoplasm of kidney, except pelvis secondary malignant neoplasm of brain and spinal cord iron deficiency anemia, unspecified secondary malignant neoplasm of lung precipitous drop in hematocrit neurologic neglect syndrome 

Answer: The patient is high likely exposed to