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: sulfonamides / penicillins / dimetapp attending: chief complaint: abnormal echocardiagram; dyspnea on exertion for 2 weeks major surgical or invasive procedure: none history of present illness: 66f w/ a hx of anxiety, renal cell carcinoma 13 yrs ago, s/p nephrectomy, who was sent to the ed from her pcp??????s office after presenting with a panic attack and was found on exam to have a new systolic murmur. a tte on showed severe supravalvular pulmonic stenosis with rv hypertrophy and dilation, ef 55%. she reports doe x 2 weeks and no other symptoms, including no cp, orthopnea, pnd, edema, fainting, lightheadedness. she does have a chronic morning cough from post-nasal drip. past medical history: renal cell carcinoma -- dx in , s/p nephrectomy of right kidney, no chemo, no distant mets. s/p appy s/p cholecystectomy s/p hyperectomy for endometriosis social history: no tobacco, etoh or drugs. lives in w/ husband. 4 children. not working. former salesperson. family history: daughter with cervical cancer, mother with cancer, father with dm physical exam: vitals: t 97.9 hr 80s reg bp 110-144/80s-90s rr 18 94-96% on ra ?????? after 1.5 flights of stairs, o2 sat 92-97% with no cp, some sob, hr to 110s. gen: well-groomed elderly female who looks healthy, wearing make-up, lying in bed wide awake. skin: warm, dry. large (~1cm) pigmented lesion on right upper back with central lack of pigmentation, which pt says has been biopsied by a dermatologist as ??????normal.?????? heent: normal nodes: none palpable; no thyroid masses heart: jvp 6 cm. iii/vi systolic murmur loudest at rusb and lusb. no rubs, no s3 or s4 lungs: cta abd: soft, non-tender, no masses, no organomegaly. extrem: no edema. no calf tenderness. legs equal in size. warm bilat. neuro/psy: anxious, but not actively panicking. pertinent results: -chem-7 wnl -cbc wnl -cxr : unremarkable -echocardiogram : possible extrinsic compression of the main pulmonary artery; severe supravalvular pulmonic stenosis; mr imaging or ct scanning recommended to delineate the cause of pulmonic stenosis -cta : low-density lesion in main pulmonary artery, measuring 2 x 3 cm in diameter, with extensive coarse calcification. the etiology is uncertain, however, this can represent myxoma with calcification, and osteogenic sarcoma. diffdx includes neoplasm including metastasis from renal cell carcinoma, or angiosarcoma or other mesenchymal tumor. alternatively, this can represent thrombus with calcification or migrated iatrogenic material if the patient has appropriate history. -tee : normal lv systolic fxn (lvef>55%). rv cavity dilated. rv fxn could not be accurately assessed. pulmonary valve not well seen. scattered calcifications in the main pulmonary artery at the level of the pulmonic valve. turbulent flow in the main pulmonary artery consistent with obstruction. other valves wnl. -repeat creat after cta chest and hydration with bicarb: 1.2->1.3 -panorex films : wnl brief hospital course: 66f with h/o anxiety, renal cell ca yrs ago sent to ed fr pcp's office after outpt echo showed severe pulm art htn. new doe (e.g., going up stairs) x 2 wks. ros o/w noncontributory. admitted to medicine for evaluation of her pulmonary htn and workup of the pulmonic stenosis. # pulmonary valve stenosis and pulm artery mass: a tte prior to admission showed severe supravalvular pulmonic stenosis suggestive of a compressed pulmonary artery. pt refused all closed mri studies, even with premedication, due to fears of claustrophobia but pt agreed to a ct chest with contrast. ct showed a 3.2 cm calcified mass in her main pulmonary artery. the diffdx included a calcified thrombus, metastatic renal cell carcinoma (likely from a new primary in her remaining kidney), myxoma, or sarcoma (though very rare). hematology-oncology was consulted and suggested a renal u/s or ct to evaluate for a new rcc primary. renal u/s showed no definite evidence of disease recurrence within the right nephrectomy bed, although this study was limited by pt's body habitus. interventional cardiology was consulted and performed cardiac cath on to further evaluate new pulm stenosis. cath revealed elevated right sided pressures (rv 113/13 mmhg) and normal pulmonary pressures (pa 26/19 mmhg) with a calculated pulmonary valve area of 0.29 cm and a gradient of 35.68 mmhg between the rv and the pa. intravascular ultrasound showed a significant and large calcific plaque distal the pulmonary valve. the pulmonary valve was not well visualized, but did not appear mobile. based on this information, thoracic surgery was consulted and the patient was brought to the or for surgery on for both pulmonic valve replacement and pulm artery mass evaluation/excision. plan outpt f/u with heme/onc based on path results. # renal: s/p nephrectomy; creat 1.1 w/1 working kidney; rec'd 75cc optiray for ct pe protocol on + hydration. creat stable throughout remainder of hospital course on medicine service. renal u/s (): no evidence of mass in left kidney or r nephrectomy bed. # fen: pt tolerated house diet well. # prophyl: maintained on h2b & sc heparin prophylaxis. # dispo: transferred to thoracics service on when pt went to or (see above). medications on admission: none discharge disposition: home with service facility: homecare discharge diagnosis: pulmonary artery hypertension; mass in pulmonary artery discharge condition: stable 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