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: r parietal mass major surgical or invasive procedure: : right craniotomy for tumor resection history of present illness: this is a 58 year old gentleman with history of renal cell ca in status post nephrectomy presented to hospital on with complaints of headache, fatigue and slight gait instability. ct head was performed and revealed right temporal/parietal lesion with significant edema/mls. he was given decadron but left against medical advice because he wanted to attend his son's rehearsal dinner instead of being transferred to the . he presentd again on to establish care, receive any necessary medications and make sure that he is safe to attend his son's wedding on the next day. he did not want to be admitted but agreed to perform necessary tests prior to leaving the emergency department. he states that he was recently evaluated by his nephrologist last week and a follow up ct of his kidneys was negative for recurrance. he apparently also had a chest xray 4 months ago that was negative. mr did explain that he was offered an experimental chemo after his nephrectomy but declined. he returned for an elective resection on . past medical history: renal cell ca status post nephrectomy in social history: married, smokes approximately 1/2-1ppd since teens, 4-6 beers per day, denies drugs. employed part time in construction. family history: non contributory physical exam: pre-op: physical exam: o: t:97.8 bp: 131/77 hr:92 r 20 o2sats 98% ra gen: wd/wn, comfortable, nad. heent: pupils: perrl eoms intact neck: supple. lungs: cta bilaterally. cardiac: rrr abd: soft, nt 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. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 4 to 3 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. 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 coordination: left dysmetria. rapid alternating movements and heel to shin intact on the day of discharge - the patient was intact. strength was . the patient was oriented to person, place, and time. eoms were intact. face symetric. ambulating independently pertinent results: mr head w & w/o contrast - patient unable to tolerate due to anxiety. head ct : impression: status post right parietal mass resection with small amount of blood and gas in the resection bed, surrounding vasogenic edema head ct : impression: stable appearance of the brain compared with . no new area of hemorrhage or extension of edema seen or hydrocephalus noted. mr head w/ contrast study date of 10:36 am impression: right parietal enhancing lesion is identified for surgical planning on this presurgical study (markers were placed on the surface for surgical planning). overall, the appearances of the enhancing lesion and surrounding brain are unchanged compared to pathology report tissue: possible metastatic tumor, study date of report not finalized. assigned pathologist ,hasini please contact the pathology department, pathology # possible metastatic tumor, chest (pre-op pa & lat) study date of 2:32 pm impression: no pneumonia, effusion, or edema. cardiology report ecg study date of 1:59:34 pm sinus rhythm. possible left atrial abnormality. no previous tracing available for comparison. read by: , k. intervals axes rate pr qrs qt/qtc p qrs t 75 126 92 45 05:23pm type-art po2-235* pco2-35 ph-7.41 total co2-23 base xs--1 intubated-intubated 05:23pm glucose-117* lactate-2.6* na+-133* k+-4.5 cl--102 05:23pm hgb-13.7* calchct-41 05:23pm freeca-1.08* 03:22pm type-art po2-222* pco2-40 ph-7.37 total co2-24 base xs--1 03:22pm glucose-114* lactate-1.4 na+-130* k+-4.0 cl--100 03:22pm hgb-13.5* calchct-41 03:22pm freeca-1.09* 02:05pm urea n-21* creat-1.4* 02:05pm wbc-9.4 rbc-4.63 hgb-14.6 hct-43.3 mcv-94 mch-31.6 mchc-33.8 rdw-13.2 02:05pm plt count-278 09:15am blood wbc-10.8 rbc-4.27* hgb-13.8* hct-40.2 mcv-94 mch-32.3* mchc-34.3 rdw-12.9 plt ct-278 09:15am blood plt ct-278 09:15am blood pt-10.6 ptt-21.2* inr(pt)-0.9 09:15am blood glucose-97 urean-17 na-138 k-3.8 cl-100 hco3-27 angap-15 09:15am blood calcium-9.2 phos-4.0 mg-2.2 09:15am blood phenyto-9.5* brief hospital course: this is a 58 year old male elective admission for right crani for tumor resection on . intraoperatively, there were no complications, a subdural drain was placed. post-operatively he was kept in the neuro intensivecareunit overnight for observation. his post-operative head ct was stable. there were no exam changes. on , the patient was awake and alert. he was ready for floor transfer but the patient became very agitated and aggressive. he was trying to leave to have a cigarette. a code purple was called and the patient was given ativan and haldol. a repeat head ct was stable and showed no acute hemorrhage. he was kept in the icu overnight. his decadron was discontinued because of the steroid induced psychosis. on , he was oriented and his affect/behavior was at baseline. his subdural drain was removed and staples were placed. he was transferred to the floor. he went to mri but was unable to tolerate secondary to anxiety and chest tightness. his vitals remained stable. a ekg was stable. he returned to the floor. the patient ws tolerating a regular diet. on , the patient was alert and oriented to person place and time. his strength was full. there was no pronator drift. pupils were recative and extraocular movements were intact. bowel sounds were present. the patient was not anxious or aggitated. the patient was able to void on his own. it was explained that since he was unable to tolerate the mri post operatively, that he will now need to have a mri with and without contrast prior to his follow up in the brain clinic in 4 weeks.physical therapy evaluated the patient today and found that while he is independent with ambulation , the he would benefit from high level balance training on an out patient basis with physical therapy. medications on admission: none discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 2. senna 8.6 mg capsule sig: one (1) capsule po once a day for 4 weeks: hold for loose stools. :*28 capsule(s)* refills:*0* 3. bisacodyl 5 mg tablet sig: one (1) tablet po once a day for 4 weeks: hold for loose stools. :*28 tablet(s)* refills:*0* 4. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain: do not drive while taking, hold for lethargy. :*60 tablet(s)* refills:*0* 5. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 6. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po tid (3 times a day) for 7 weeks: please have your level drawn in one week at your pcp. :*90 capsule(s)* refills:*2* 7. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 8. outpatient lab work dilantin level in one week please fax result to 9. outpatient physical therapy for high level balance trainaing- please call to make an appointment this week discharge disposition: home discharge diagnosis: right parietal brain mass discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. physical therapy has seen the patient and discharged him with recommendation for high level balance training on a outpatient basis. discharge instructions: general instructions/information ?????? 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 staples have been removed. ?????? 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. ?????? you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed until follow-up when we will decide if this is still needed. you will need your level drawn in one week with the result faxed to our office. the office fax number is . ?????? 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. followup instructions: you will need to be see at the brain clinic in weeks with a mri of the brain with and without contrast. please call the office on tuesday to set up an apointemnt or if your have and questions you may call them at . as we were unable to get an mri while you were inpatient, you will need one for follow-up. you will need to return to dr clinic for staple removal 10 days from surgery. please call . any questions or concerns please call. procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: tobacco use disorder adrenal cortical steroids causing adverse effects in therapeutic use secondary malignant neoplasm of brain and spinal cord cerebral edema personal history of malignant neoplasm of kidney acquired absence of kidney unspecified drug-induced mental disorder 

Answer: The patient is high likely exposed to