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: no known allergies / adverse drug reactions attending: chief complaint: ataxia, gait disturbance, slowed speech, balance/coordination problems major surgical or invasive procedure: posterior fossa craniectomy resection of tumor history of present illness: 58 yo m with h/o nsclc diagnosed in s/p lllobectomy and chemoradiation with new primary small cell lung cancer on the right diagnosed by biopsy and treated with chemotherapy presents with approx 1 week of slowed speech without aphasia, wide based gait, and balance and coordination issues. ct from an osh shows two masses, one in the l parietal lobe and one in the l cerebellum along with developing hydrocephalus. past medical history: lung cancers as above, hypertension, gerd, copd, social history: previous heavy etoh (5+ beers/day, stopped 8 days ago, never diagnosed with liver disease), previous heavy smoker 60-80 pack-years in total, no illicits. family history: nc physical exam: o: t: 98.5 bp: 126/80 hr: 104 r 16 o2sats 97%ra gen: wd/wn, comfortable, nad. heent: pupils: b, eoms full with left beating nystagmus on left gaze lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension and repetition. naming intact. slowed speech rate but no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 4 to 2 mm bilaterally. iii, iv, vi: extraocular movements intact bilaterally with l beating nystagmus on l gaze. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout. no pronator drift sensation: intact to light touch bilaterally. reflexes: b t br pa ac right 1 1 1 1 1 left 1 1 1 1 1 toes downgoing bilaterally coordination: mild dysmetria on fnf, normal , gait wide-based with ataxia on discharge: a&ox3 perrl eoms intact face symmetrical tongue midline no pronator drift minimal dysmmetria incision: c/d/i full strength throughout pertinent results: ct : 2 large 4+cm cystic masses, one in the cerebellum and one in the l parietal lobe labs: chem 135 92 10 121 agap=16 4.0 31 0.8 ca: 9.7 mg: 1.7 p: 3.9 cbc: 10.2 15.3 513 44.7 n:84.4 l:8.0 m:5.5 e:1.3 bas:0.8 pt: 13.0 ptt: 26.3 inr: 1.1 mri brain - large necrotic masses with enhancing wall and solid components in the left temporal lobe and left cerebellum. the left cerebellar lesion is causing significant mass effect on the fourth ventricle. lesions are consistent with metastases. no evidence of transependymal signal change to suggest acute hydrocephalus. ct brain - 1. status post left occipital craniectomy for resection of left cerebellar mass. there is expected pneumocephalus and post-surgical change, as well as a 1.5 x 2.6 cm post-operative hematoma in the resection bed. continued close imaging followup is warranted. 2. stable appearance of necrotic mass in the left temporoparietal region, with local mass effect upon the left lateral ventricle and no significant shift of midline structures. mr head w & w/o contrast the patient is status post left occipital tumor resection in the left cerebellar hemisphere, the expected surgical changes are visualized consistent with blood products and air in the surgical cavity, this lesion has been decreased in size since the prior study and the surgical bed is filling with blood products and csf. supratentorially the cystic necrotic mass lesion is redemonstrated with internal nodularity and enhancement, relatively unchanged since the prior study. no new metastatic lesions are visualized since the most recent examination. brief hospital course: pt was admitted to the icu for close neuromonitoring. a brain mri obtained on demonstrated enhaninc cystic lesion in the left cerbellar region and left temporal region consistent with metastasis. surgical itervention was recommend and on , he was taken to the or where under general anesthesia he underwent posterior fossa craniectomy resection of tumor. he tolerated this procedure well and was extubated without incident. he returned to icu in stable condition. a post-op ct demonstrated post-operative changes with hyperintensity in the surgical bed likely surgical material and mild hemorrhage. his icu course was uncomplicated. he was started on subcutaneous heparin and mri was done. dilantin level was 9.8. mri showed reduced size of lesion with blood in surgical bed, no new metastatic lesion were seen. patient was transferred to the floor. on , patient was nonfocal on examination, pt cleared him for home and he was discharged to follow up in brain tumor clinic on the . medications on admission: enalapril, omeprazole, trazodone,ambien, multiple inhalers discharge medications: 1. dexamethasone 2 mg tablet sig: two (2) tablet po twice a day. disp:*120 tablet(s)* refills:*2* 2. dilantin extended 100 mg capsule sig: one (1) capsule po three times a day. disp:*90 capsule(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 7. salmeterol 50 mcg/dose disk with device sig: one (1) disk with device inhalation q12h (every 12 hours). 8. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 9. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*80 tablet(s)* refills:*0* 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* discharge disposition: home discharge diagnosis: left cerebellar mass left temporal mass discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. if your wound closure uses dissolvable sutures, you must keep that area dry for 10 days. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: redness, swelling, tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please return to the office in days(from your date of surgery) for removal of your sutures and/or a wound check. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????please call ( to schedule an appointment with dr. , to be seen in 6 weeks. ??????you will need a ct scan of the brain without contrast. ?????? you also have a brain clinic appointment scheduled for you on at 10:30am with dr. . his office is located on the . please call md procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: obstructive hydrocephalus esophageal reflux unspecified essential hypertension chronic airway obstruction, not elsewhere classified compression of brain secondary malignant neoplasm of brain and spinal cord malignant neoplasm of other parts of bronchus or lung 

Answer: The patient is high likely exposed to