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: penicillins attending: chief complaint: abdominal pain, melena major surgical or invasive procedure: liver biopsy history of present illness: mr is 65m former orthopedic surgeon who initially presented to the ed with dyspnea and melanotic stools. he has been feeling dyspneic for 1-2 weeks prior to presentation accompanied by epigastric pain that radiated to his back. patient initially thought the pain was coming from his gallbladder - he requested a ruq u/s from his pcp, which a mass was discovered in his liver. the mass was 15 cm per report. ct with po and iv contrast was then obtained to better define the mass and confirmed a large mass in his left lobe. he underwent egd that showed a mass in the cardia. per patient's report, the biopsy of the mass was nondiagnostic, however he was told it was likely a leiomyosarcoma based on the location. he was due to get an eus on . however, before that could happen, he had an episode of melena and felt lightheaded. he therefore presented to the ed with concern for an ugi bleed. in the ed, sbp was 120 and hr was in the 70s. he was admitted to the micu for serial hcts and for egd. gi performed egd and it revealed a 6 cm submucosal lesion with 3 areas of ulceration. the mass was quite friable and started to ooze a bit with manipulation, and so a biopsy was unable to be obtained. a surgical consult was initially placed to dr. . however, he suggested the consult be directed to dr. . past medical history: bph, leiomyosarcoma with mets to liver, ruptured biceps tendon, ?iga deficiency social history: former orthopedic surgeon, now practices as an attorney. lives with his wife who is his hcp. tobacco use. drinks glasses wine/night. no ivda family history: grandfather with ca - lived to age of 95. physical exam: physical exam on admission: vitals: t 98.0, hr 64, bp 100/64, rr 16, o2 98%ra gen: nad, a&o x 3 h&n: no palpable lns, no scleral icterus lungs: clear b/l cv: rrr, nl s1 and s2 abd: soft, nd, slightly ttp in epigastric region, no hernias, no masses ext: no c/c/e rectal: guaiac neg, large prostate physical exam on discharge: af vss gen: nad, a&ox3 heent: perrl, eomi, mmm rrr: rrr pulm: ctab, no respiratory distress, no w/r/r abd: s/nd, mild epigastric tenderness ext: warm/dry, no c/c/e pertinent results: 09:40am blood wbc-7.5 rbc-3.59* hgb-8.9* hct-28.2* mcv-79* mch-24.7* mchc-31.5 rdw-15.5 plt ct-333 06:55am blood wbc-7.4 rbc-4.24* hgb-10.8* hct-34.3* mcv-81* mch-25.5* mchc-31.5 rdw-16.7* plt ct-278 09:40am blood neuts-62.5 lymphs-32.0 monos-3.2 eos-2.0 baso-0.3 09:40am blood pt-12.8 ptt-25.3 inr(pt)-1.1 06:55am blood pt-12.7 ptt-26.4 inr(pt)-1.1 09:40am blood glucose-119* urean-30* creat-1.0 na-140 k-4.2 cl-106 hco3-25 angap-13 06:55am blood glucose-99 urean-9 creat-1.0 na-142 k-4.6 cl-105 hco3-28 angap-14 09:40am blood alt-57* ast-37 alkphos-132* totbili-0.3 06:55am blood calcium-9.5 phos-3.9 mg-1.8 03:00am blood caltibc-408 vitb12-483 folate-11.6 ferritn-64 trf-314 03:00am blood tsh-4.1 07:15am blood hcg-<5 03:00am blood cea-1.1 afp-9.3* 03:00am blood iga-less than 09:40am blood iga-less than 11:01am blood ca -9 -test imaging: spiral ct w/ triple phase contrast: 1. large heterogeneously enhancing mass predominantly centered about the fundus of the stomach as detailed above with overall features concerning for gist tumor. 2. three heterogeneously enhancing masses within the liver as detailed above with a large left hepatic mass resulting in replacement and expansion of the left lobe, and discrete masses within segments v and vi of the liver, concerning for metastasis. . xr l hip: no metastatic disease. . u/s-guided liver biopsy: 1. technically successful percutaneous targeted biopsy of liver mass under real-time ultrasound guidance. post-procedure orders were entered into the provider order entry system. . egd: large subepithelial mass with three deep cratered ulcers were noted in the gastric cardia - these ulcers are not amenable to endoscopic therapy. otherwise normal egd to second part of the duodenum brief hospital course: the patient was admitted to the micu. serial hcts were checked and he was transfused 2 units of prbcs. an emergent egd was performed which revealed a large 6cm submucosal lesion with 3 areas of ulceration. a biopsy was not performed as the tissue looked very friable. afterwards, the patient's hct stabilized and his melena stopped. as the patient was stable, he was transferred to the floor. the heme/onc team was consulted. they recommended obtaining a biopsy of the liver mass to establish a tissue diagnosis. the patient therefore underwent ultrasound-guided biopsy of the liver mass on . on the same day, the patient underwent spiral ct with triple phase contrast to better define the liver metastases. once these images were obtained, the hepatobiliary team was consulted about possible resectability. the report noted that the mass was consistent with a gist tumor. the patient was discharged home the next day. though he still had epigastric pain, he was otherwise doing well. he was afebrile with stable vital signs. his hct had been stable and he had no more episodes of melena. he was out of bed and ambulating independently and voiding without problems. medications on admission: dutasteride 5mg po qhs, terazosin 2 mg po qhs discharge medications: 1. finasteride 5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. terazosin 2 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: gastric mass with hepatic metastasis upper gastrointestinal hemorrhage discharge condition: good/stable discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *avoid driving or operating heavy machinery while taking pain medications. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. followup instructions: please call dr. office to schedule a follow-up appointment. procedure: other endoscopy of small intestine closed (percutaneous) [needle] biopsy of liver diagnoses: malignant neoplasm of liver, secondary acute posthemorrhagic anemia gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction hemorrhage of gastrointestinal tract, unspecified malignant neoplasm of cardia nonspecific low blood pressure reading selective iga immunodeficiency 

Answer: The patient is high likely exposed to