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: history of present illness: ms. is a 66-year-old woman with a history of renal cell ca treated 13 years ago with a right nephrectomy. no chemo or distant mets at that time. presented to her primary care provider with an anxiety attack, crying, mental anxiety, no physical symptoms who at that time was noted to have a new heart murmur. also had a history of 2 weeks of dyspnea on exertion with climbing stairs and no shortness of breath at rest. no chest pain, no lower extremity edema, no fatigue, no night sweats, no weight loss, no hematuria or abdominal pain. an echo done on showed a dilated right ventricle with hypertrophy and depressed function, consistent with rv pressure overload, severe pulmonary stenosis. a cat scan also done at that time showed a 2-3 cm mass in the main pulmonary artery with calcifications. past medical history: significant for renal cell ca, diagnosed in . last renal ultrasound was in , normal left kidney, status post ccy, status post appendectomy, status post hysterectomy. medications: aspirin. allergies: penicillin, sulfa and dimetapp. family history: daughter with cervical ca and mother with ca. cousin with renal cell ca. social history: no tobacco, former saleswoman. physical exam: general: no acute distress. neck: no jvd. no bruits. lungs: clear to auscultation bilaterally. cardiovascular: regular rate rhythm with a 3/6 systolic murmur at the right upper sternal border. abdomen is soft, nontender, nondistended with positive bowel sounds and no masses. extremities with no edema. laboratory data: white count 12.4, hematocrit 41.2, platelets 263, sodium 140, potassium 4.9, chloride 106, co2 of 22, bun 21, creatinine 1.2, glucose 92. chest x-ray shows no acute cardiopulmonary process. cta shows a 2-3 cm mass in the main pulmonary artery with calcifications. hospital course: the patient was admitted to the medical service. thoracic surgery as well as a heme consult were called at that time. following an extensive workup which includes ultrasound, tee, mra and cardiac catheterization which showed normal coronaries and a large calcific plaque distal to the pulmonary vein, the patient was ultimately scheduled for pulmonary vein homograft repair with excision of the pulmonary artery mass and on , the patient was brought to the operating room. please see the or report for full details. in summary, the patient had a pulmonary artery resection with excision of a mass and replacement with a 27 mm homograft. additionally the patient had a pda ligation. the patient's bypass time was 204 minutes with no cross-clamp time. she tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time transfer, the patient had milrinone at 0.25 mcg/kg/min, neo at 1.5 mcg/kg/min and propofol at 30 mcg/kg/min. the patient did well in the immediate postoperative period. however, following reversal of anesthesia, the patient trended down hemodynamically. she was therefore re-sedated and the decision was made to keep her intubated and to attempt to wean on postoperative day two. on postoperative day two, the sedation was again weaned. the patient tolerated the wean initially. however following the initial wean, she had oxygenation problems and was again sedated and fully ventilated. at that time, a decision was made to change sedatives with an additional attempt to wean to extubate on postoperative day three. the patient remained hemodynamically stable throughout these episodes. ultimately on postoperative day three, the patient successfully weaned from the ventilator and extubated. following extubation, the patient's milrinone infusion was also weaned as were her neo-synephrine infusion. on postoperative day four, the patient continued to be hemodynamically stable. her milrinone was discontinued. her swan-ganz catheter was removed. the chest tubes, foley catheter and temporary pacing wires were also removed and the patient was begun on beta blockade as well as standing diuretics. the patient remained in the icu for hemodynamic monitoring as well as respiratory monitoring. on postoperative day five, the patient continued to look well and was transferred to the floor for continuing postoperative care and rehabilitation. once on the floor, the patient had an uneventful postoperative course. her activity level was increased with the assistance of the nursing staff and physical therapy staff and ultimately on postoperative day 14, the decision was made that the patient was stable and ready to be discharged to home. at the time of this dictation, patient's physical exam is as follows. vital signs: temperature 98.4, heart rate 86, sinus rhythm, blood pressure 95/63, respiratory rate 18, o2 sat 93 percent on room air. laboratory data: white count 12.3, hematocrit 34.6, platelets 393, sodium 136, potassium 4.5, chloride 105, co2 of 19, bun 17, creatinine 1.0, glucose 102. physical examination: neuro: alert and oriented times three. moves all extremities. follows commands. respiratory: somewhat diminished at the bases. otherwise,clear to auscultation. cardiovascular: regular rate and rhythm, s1-s2. distant heart sounds. sternum is stable. incision with steri-strips open. abdomen: soft, nontender, nondistended with normoactive bowel sounds. extremities: warm and well-perfused with no edema. initial read of pa mass biopsy is renal cell versus sarcoma, more likely sarcoma than renal cell. pathology to be further identified. condition on discharge: patient's condition at discharge is good. she is to be discharged home with vna. discharge diagnoses: status post excision of pulmonary artery mass and homograft repair with pda ligation, status post nephrectomy, status post ccy, status post tah and anxiety. fop: the patient is to have follow-up in the clinic in 2 weeks. she is to have follow-up with dr. on at 1:00 p.m. follow-up with dr. in weeks and follow-up with dr. in 4 weeks. discharge medications: 1. colace 100 mg b.i.d. 2. aspirin 325 mg once daily. 3. potassium chloride 20 meq once daily times 2 weeks. 4. lasix 20 mg once daily times 2 weeks. 5. lopressor 50 mg b.i.d. 6. tylenol with codeine 300/30, one-half to one tablet p.o. q.4-6h. 7. klonopin 0.25 mg p.o. q.8h. p.r.n. , m.d. procedure: extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters diagnostic ultrasound of heart arteriography of pulmonary arteries right heart cardiac catheterization other surgical occlusion of vessels, thoracic vessels open and other replacement of pulmonary valve with tissue graft other excision of vessels, thoracic vessels diagnoses: patent ductus arteriosus secondary malignant neoplasm of other specified sites primary pulmonary hypertension personal history of malignant neoplasm of kidney panic disorder without agoraphobia pulmonary valve disorders malignant neoplasm of connective and other soft tissue of thorax 

Answer: The patient is high likely exposed to