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: headache major surgical or invasive procedure: left subdural hematoma evacuation free latissimus flap scalp stress mibi burr holes for subdural collection history of present illness: 85 y/o female with a history of squamous cell carcinoma resected from her forehead approximately 18 months ago. the patient did well following the procedure, and physicians were under the impression that the surgical margins were clean. approximately 6 months ago she noted progressive difficulty with ambulation and over the past 2-3 weeks increasing headaches. she denies any falls or head trauma during this period,however,head ct obtained at an outside hospital reveals left frontal parietal chronic subdural hematoma approximately 1.7cm in thickness with 1.2cm midline shift. there is no evidence of acute hemorrhage, but left frontal bone superior to the orbit is eroded with possible local invasion of carcinoma. pt presented to for cranioplasty with free flap. past medical history: pmhx: atrial fib hypothyroidism cad low back pain squamous cell carcinoma of the forehead social history: social hx: denied tobacco, etoh, or ivdu; she lived alone at home - retired family history: family hx: noncontributory physical exam: physical exam: gen: appears cachectic, unconscious, nad. heent:cerebral flap w/xeroform and gauze, depressed cranium pupils: bilaterally neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+, ngt d/c'd extrem: warm and well-perfused. neuro: mental status: unconscious, not following commands, no eye opening, spontaneous movement of all extremeties, bue's contracted with extensive posturing to noxious stimuli. orientation: uta-unconscious language: nonverbal cranial nerves: i: not tested ii: pupils equally round and reactive to light, 2 to 1.5mm bilaterally. iii, iv, vi: not tested v, vii: not tested viii: not tested ix, x: not tested : not tested xii: not tested motor: bue's contracted, extend to noxious stimuli, ble's with min w/d to deep noxious stimuli pertinent results: scalp pathology results: clinical: 85 year old woman with metastatic tumor, frontal scalp involving skull and dura. the tumor from all five specimens shows similar features. tumor cells are epithelioid, pleiomorphic and variably discohesive. nuclei are enlarged and irregular and many are vesicular with prominent nucleoli. mitotic figures are frequent. in the skin excision tumor is present in the dermis and extends to involve the deep subcutaneous tissue. an origin from the epidermis is not identified nor is there definitive morphologic evidence of squamous differentiation. immunohistochemical stains show the tumor to be immunoreactive for vimentin. a large subpopulation of tumor cells are immunoreactive for cytokeratins as pankeratins (ae1/ae3/cam 5.2), mnf 116 and focally for cytokeratin and ema, and to show strong nuclear reactivity for p63. there is variable reactivity in a subset of cells for cd138, cd31, cd68 and cd45. they are non-reactive for the melanocytic markers s-100, mart-1, hmb-45, cytokeratins -7 and -20, cd79, cd34, factor viii, ttf-1 or the estrogen receptor. the morphologic features in conjunction with these immunohistochemical findings favor that this tumor is a poorly differentiated carcinoma. it may represent extension / recurrence of a tumor originally located at or near this site but a distant metastasis cannot be excluded. correlation with the clinical findings is suggested. ct head w/o contrast 11:09 am reason: f/u study medical condition: 85 year old woman with s/p bifrontal craniectomy, in sicu reason for this examination: f/u study indication: status post bifrontal craniectomy, in cicu; assess interval change. comparison: . technique: non-contrast head ct. findings: stable appearance of large hypodensity involving the left frontal lobe with a central high- attenuation focus with unchanged rightward shift of normally midline structures (10 mm). stable appearance of left subdural collection. the basilar cisterns and ventricular system are stable in size. again seen are air-fluid levels in the sphenoid sinuses. impression: essentially unchanged head ct from . head ct: findings: there is worsened subfalcine herniation today with the midline shift measuring 15 mm, previously 10 mm, with worsening effacement of rightwardly displaced left ventricle. there is worsened uncal herniation with increased shift towards the midline of the temporal . the large hypodensity involving the left frontal lobe appears increased in size today at 5.5 cm (previously 5.2 cm) again containing a central hyperdensity that has slightly decreased in size. the left subdural collection appears essentially stable. air-fluid levels are again seen in the sphenoid sinuses. impression: worsening subfalcine and uncal herniation with slightly increased size of left frontal hypodensity and stable-appearing left subdural hematoma. bilateral lower extremity ultrasound: findings: ultrasound evaluation of the right and left lower extremity deep venous system using grayscale, color, and pulse wave doppler reveals the veins to be fully compressible with normal color flow, doppler waveforms, augmentation, and respiratory variation in flow. impression: no evidence of dvt involving the right or left lower extremity. echo: findings left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv wall thickness. normal lv cavity size. overall normal lvef (>55%). transmitral doppler and tvi c/w grade i (mild) lv diastolic dysfunction. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. aortic valve: mildly thickened aortic valve leaflets. no as. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild thickening of mitral valve chordae. of the mitral chordae (normal variant). no resting lvot gradient. trivial mr. lv inflow pattern c/w impaired relaxation. tricuspid valve: mildly thickened tricuspid valve leaflets. mild tr. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. pericardium: no pericardial effusion. conclusions the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). transmitral doppler and tissue velocity imaging are consistent with grade i (mild) lv diastolic dysfunction. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: ms was admitted to neurosurgical icu on for left frontal parietal chronic sdh with midline shift. there is also erosion to left orbit with possible local invasion of skin carcinoma. she was taken to the or on hd#2 for evacuation of left subdural hematoma. she underwent the procedure and remained intubated until pod#2. her mental status improved after the surgery. she self d/c'd ngt on ; she passed bedside swallow evaluation on and her po diet was resumed. she underwent latissimus flap cranioplasty by plastic services on and she tolerated the procedure well with no complications. postoperatively she was transfered back to the icu intubated with 1 penrose, 2 jp drains, xeroform over the donor skin graft site, and xeroform over the flap. she was extubated on without difficulty. she slowly improved to the ability to follow commands and open eyes to voice. plastic services continued to follow her throughout her hospitalization. she was evaluated by speech and swallowing on and was recommended npo until further re-eval. on the patient became less responsive and less able to follow commands. repeat head ct showed left frontal infarct/increasing sdh with increased midline shift. she was taken back to the or for a craniotomy for evacuation of sdh. she stayed in icu postop and was extubated on . neurologically she opens eyes spontaneously, but following commands inconsistently. she has mild weakness with rue and with lue; she moves both le antigravity. repeat cth with slight worse l sdh, and stable on cth . she was transferred out of icu to stepdown on and was started with pt and chest pt. patient's mental status slowly deteriorated to more somnolence, not open eyes and inconsistently following commands. she was tachypneic sometimes with o2 sat maintained in 90s on humidified room air. cxrs are negative for pneumonia; her breathing pattern improved with atrovent inhalor and expectant guaifenesin. **************** family meeting took place on ,at which point the decision was to refocus care towards comfort measures only. see palliative care note as follows: date: signed by , np on affiliation: private practice request to meet family to discuss hospice care. family spoke with neurosurgery this morning and have changed focus of care to comfort with hospice care. pt is 85 yo woman with sq. cell cancer with multiple surgeries, recent subdural with evacuation but no response. after aggressive care to maintain while hoping for mental status improvement, pt has not made any gains and has remained unresponsive. her brother and her neice are hcp and both agree she would not want her life prolonged if unable to recover. discussed with her neice she understands move to hospice level of care will mean d/c ngt, no ivf, meds for comfort only. at the pt may receive hospice services dependent on insureance and family wishes. will request hospice eval once pt goes to > ** upon discharge, she is in bed, unrespsonsive. rr high 20s but unlabored. her mouth is open and very dry. has humidified air on. case mgmt working on transfer to area . acetaminophen 650 mg pr q4 prn fever ativan 1-2 mg sl ( tablets may be used sl after mostening mucosa) q2 prn agitation/seizures/dyspnea morphine 5-20 mg sl q2 prn distress medications on admission: metoprolol 25 qd levoxyl 12.5 qd boniva lipitor 20 qd folic acid coumadin discharge medications: 1. lorazepam 1 mg tablet sig: 1-2 tablets po q2h (every 2 hours) as needed. 2. acetaminophen 650 mg suppository sig: one (1) suppository rectal q4h (every 4 hours) as needed. 3. morphine concentrate 20 mg/ml solution sig: 5-20mg po q2h (every 2 hours) as needed for distress. 4. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). discharge disposition: extended care facility: liberty commons nursing & rehab center - discharge diagnosis: squamous cell carcinoma cranioplasty via latissimus flap subdural hematoma evacuation x 2 on left side discharge condition: neurologically patient with poor prognosis. discharge instructions: -pt may have drain pulled out when output<30cc/hr. -cranial dressing - may leave on xeroform and change gauze dressing as needed -comfort measures as ordered by rehab. followup instructions: pt's care redirected to comfort measures. procedure: enteral infusion of concentrated nutritional substances other skin graft to other sites other incision of brain other incision of brain other cranial osteoplasty other repair of cerebral meninges lobotomy and tractotomy extracapsular extraction of lens by linear extraction technique application or administration of an adhesion barrier substance revision of pedicle or flap graft partial ostectomy of other facial bone diagnoses: unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status compression of brain personal history of other malignant neoplasm of skin secondary malignant neoplasm of brain and spinal cord encounter for palliative care subdural hemorrhage cerebral artery occlusion, unspecified with cerebral infarction aphasia secondary malignant neoplasm of bone and bone marrow 

Answer: The patient is high likely exposed to