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: chief complaint/history of present illness: mr. is a 78-year-old man with a history of laryngeal squamous cell carcinoma status post x-ray therapy initially in with a subsequent left-sided partial laryngectomy due to local recurrence, ultimately receiving a total laryngectomy in . he did well from that point on prior to admission, and was seen by dr. his old laryngologist on for left neck pain believed to be due to tmj, as well as a left external auditory canal insect bite. his stoma examination at that time was within normal limits. he recently, however, was found to have a mediastinal mass noted on chest x-ray that was 5 x 6 cm. this caused significant tracheal deviation to the right. a biopsy revealed poorly differentiated squamous cell carcinoma similar to the biopsy from . he presented on with increasing dyspnea and a 1- to 2-day history of throat tightness. past medical history: polycythemia. squamous cell carcinoma of the larynx. history of dvt and pe. forehead squamous cell carcinoma. allergies: no known drug allergies. medications: 1. spironolactone. 2. coumadin. 3. lasix. 4. hydroxyurea. 5. prevacid. 6. verapamil. 7. k-dur. hospital course: on admission, he was afebrile, pulse 84, blood pressure 142/67, respiratory rate 14, and saturating 98 percent on room air. he was alert and oriented x 3, aphasic, in no acute distress. he has a right frontal scar 2-3 cm that is well healed. pupils equal and reactive. tracheostomy site clean, dry and intact with tracheostomy collar, a large anterior mass inferior to the left tracheal wound. nose: large septal perforation. oral cavity and oropharynx within normal limits. tongue mobile. fiberoptic examination reveals vallecula within normal limits. no obvious mass in base of tongue or neopharynx. however, much of the view obscured by pooled saliva. fiberoptic examination through the stoma shows diffuse bulge from left shifting to right, with some narrowing of the stoma, tapering trachea to 6 x 10 cm, the lower two-thirds of the trachea to the carina within normal limits. a ct scan of the airway showed a 6 x 6 cm mass in the superoanterior mediastinum with tracheal deviation to the right, some narrowing near the superior trachea/laryngectomy stoma. no fluid collection. he was admitted to the sicu at hospital for management of dyspnea. he had continuous pulse oximetry and close respiratory monitoring. he was started on verapamil, racemic epinephrine p.r.n., a full liquid diet, plus all of his home medications, and placed on ancef empirically. laboratory data on admission: chem-7: sodium 135, potassium 3.8, bicarbonate 96, chloride 123, bun 16, creatinine 1.1 and glucose 146. white count 20.3, hematocrit 42, and platelets 48. pt 14.7, ptt 28 and inr 1.4. hospital course: he was seen by thoracic surgery on the day of admission, who recommended oncology consultation, steroids and continuous o2 saturation monitoring. he received decadron 10 mg iv q.8h. x 3 doses. thoracic surgery recommended consulting interventional pulmonology for stenting and rigid bronchoscopy. he was seen on and was made npo for possible stent placement. on , he was seen by the department of medicine in consultation for preop. the impression was, likely some degree of coronary artery disease. he had a tachy arrhythmia that was not atrial fibrillation and was continued on verapamil and cleared for surgery. on , he had a bronchoscopy showing an intact tracheostoma with a proximal tracheal lumen of mm with erythematous friable mucosa. an 18 x 40 mm covered stent was placed in the trachea and balloon-dilated to 20 mm. he was seen by radiation oncology on and was planned for palliative x-ray therapy to the upper mediastinal mass to relieve airway compression, after review of prior radiation history. he was also seen by the medical oncology team and the impression evidenced that the mass was not resectable. treatment options will include radiation with or without chemotherapy. the location of the mass outside the original localized laryngeal radiation in , may make him a candidate for additional radiation therapy to this mediastinal mass. depending on his condition following hospitalization and radiation therapy, he may be a candidate for concurrent chemotherapy, typically cisplatin, depending on medical status. a milder, gentle sensitizing chemotherapy consisting of carboplatin and taxol may be indicated depending on his physical status following hospitalization. postoperatively, the patient did well. his foley catheter was removed. thoracic surgery signed off. a -mm bloom- singer laryngectomy tube was passed by the otolaryngology chief resident after a discussion with the pulmonary fellow, about where exactly his stent was. the tube was trimmed so that it did not overlap the stent and the stoma was widely patent with the new tube. on , he was feeling well, breathing comfortably and was discharged home with vna. he was on a low-sodium, low-fat diet, with activity as tolerated. discharge medications: 1. kcl 20 meq packet b.i.d. 2. furosemide 80 mg p.o. b.i.d. 3. roxicet 5/325 mg per 5 ml, ml p.o. q.4-6h. p.r.n. for pain. 4. pantoprazole 40 mg once daily. 5. spironolactone 25 mg 2 tablets p.o. q.d. 6. verapamil 240 mg p.o. q.d. 7. hydroxyurea 500 mg p.o. t.i.d. 8. keflex 500 mg p.o. q.i.d. for 5 days. 9. colace 150 mg per 15 ml, 10 ml p.o. b.i.d. for 1 week. discharge status: to home with vna to assist with stoma care and air humidifier. to follow-up with dr. at 1:15 p.m. , m.d. procedure: insertion of endotracheal tube other operations on trachea diagnoses: unspecified essential hypertension cachexia personal history of venous thrombosis and embolism tracheostomy status malignant neoplasm of other specified sites of larynx 

Answer: The patient is high likely exposed to