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: patient recorded as having no known allergies to drugs attending: chief complaint: headache past ten days major surgical or invasive procedure: image guided right craniotomy for tumor resection history of present illness: mr. is a 57 y/o male who was in good health until 10 days ago, when he began having gradually worsening headaches. these were right-sided and throbbing and initially controlled with over the counter analgesics, but are now refractory to these. he has had no visual changes in association, no n/v or drowsiness. he does not appreciate worsening with cough/strain or sneezing. the patient denies other difficulties, such as weakness, numbness/tingling, visual loss or diplopia, speech abnormalities, gait difficulties, vertigo, dysarthria or dysphagia. he was taken to an outside hospital today, where head ct revealed an intracranial mass lesion. he was given decadron and sent to er. past medical history: renal cell carcinoma s/p l nephrectomy in , no xrt/chemo social history: lives with his daughter. infrequent etoh use. quit smoking 25yrs ago. no ivdu family history: negative for past malignancies physical exam: vs 97.9 60 150/100 12 97% gen awake, cooperative, nad heent nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck supple, no carotid bruits appreciated. no nuchal rigidity lungs cta bilaterally cv rrr, nl s1s2, no m/r/g noted abd soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted ext no c/c/e b/l skin no rashes or lesions noted neuro exam ms awake, alert and oriented x 3. speech fluent, with normal naming, , comprehension and repetition. able to follow both midline and appendicular commands. no apraxia. no dysarthria. cn i: not tested cn ii: visual fields were full to confrontation, but with extinction on the left to double simultaneous stimulation. pupils 4->2 b/l. cn iii, iv, vi: eomi no nystagmus or diplopia cn v: intact to lt throughout; cn vii: slight l nlf flattening and asymmetry cn viii: hearing intact to fr b/l cn ix, x: palate rises symmetrically cn : shrug and symmetric cn xii: tongue midline and agile motor normal bulk and tone. no pronator drift d b t we fe ff ip q h df pf te l 5 5 5 5 5- 5 5 5 5 5 5 5 sensory intact to light touch, pinprick, joint position sense, vibration throughout. no extinction to double simultaneous stimulation. reflexes br tri pat ach toes l 2 2 2 2 1 down r 2 2 2 2 1 down coordination fine finger movements, rapid alternating movements, finger-to-nose, and heel-to-shin were all normal pertinent results: 04:30pm pt-12.6 ptt-26.8 inr(pt)-1.1 04:30pm plt count-156 04:30pm neuts-87.7* lymphs-10.9* monos-1.0* eos-0.3 basos-0.1 04:30pm wbc-6.7 rbc-5.41 hgb-15.8 hct-47.0 mcv-87 mch-29.2 mchc-33.7 rdw-13.2 04:30pm estgfr-using this 04:30pm glucose-107* urea n-19 creat-1.4* sodium-140 potassium-4.4 chloride-106 total co2-25 anion gap-13 mr head w & w/o contrast 5:37 am mr head w & w/o contrast reason: evaluate lesion contrast: magnevist medical condition: 57 year old man with intracranial mass lesion reason for this examination: evaluate lesion contraindications for iv contrast: none. indication: 57-year-old mid patient, with endocranial mass lesion, to evaluate lesion. prior studies: ct of the head done on . technique: multiplanar t1- and t2-weighted imaging of the head was performed without and with iv contrast. findings: there is a large heterogeneous mass lesion, in the right temporoparietal lobes, with areas of hemorrhage, cystic change, necrosis and large solid enhancing component. the solid competent measures 5.0 x 4.3 cm. there is entrapment of the right temporal . there is surrounding significant vasogenic edema, with a leftward shift of subfalcine herniation; measuring approximately 1 cm is unchanged, allowing for technical differences, compared to the prior ct. mass effect on the right lateral ventricle, is unchanged. there is a 1.7 x 1.6 cm round focus of increased signal on the flair, with enhancement on the post-contrast images in the left parapharyngeal space, which corresponds to an abnormally enlarged lymph node, on correlation with the ct angiogram performed on the same day (series 9, image 1), however, this is not completely included on our present study. impression: 1. large heterogeneous mass lesion in the right parietal and temporal lobes, with cystic, necrotic, hemorrhagic and solid components, the solid competent measuring 5.0 cm, with significant surrounding edema, mass effect and subfalcine herniation, and entrapment of the right temporal without significant change since the ct head done the day before. 2. 1.7-cm enhancing focus in the left parapharyngeal region, representing an abnormally enlarged lymph node, representing metastatic involvement. however, this is not completely included on our present study. mr head w & w/o contrast 2:41 pm mr head w & w/o contrast reason: residual mass? contrast: magnevist medical condition: 57 year old man with parietal mass s/p resection reason for this examination: residual mass? contraindications for iv contrast: none. gadolinium-enhanced mr scan of the brain history: status post resection of right parietal mass. assess for residual tumor. technique: multiplanar t1- and t2-weighted brain imaging was obtained pre- and post-gadolinium administration. comparison study: mr scan of the brain from . findings: there is a lace-like pattern of enhancement along the anteromedial aspect of the right temporal lobe, apparently surrounding the right temporal body. there is persistent mild dilatation of the right temporal tip, but substantially reduced in extent compared to the prior preoperative study. additionally, there is presumed hemorrhage along the operative tract, more peripherally situated within the posterior aspect of the right temporal lobe. the extensive edema surrounding the formerly very large tumor appears unaltered in extent. however, overall, there is somewhat less mass effect, though there is still leftward subfalcine herniation present. numerous tiny areas of elevated t2 signal are seen within the white matter of both cerebral hemispheres, presumably representing chronic small vessel infarctions or post- inflammatory residua. there is soft tissue swelling, subgaleal in locale at the craniotomy site and there is a possible fluid collection or surgical material within the crescent- shaped space between the dura spanning the craniotomy flap and the inner table of the flap itself. there is redemonstration of the well- defined, rounded 21 mm area of contrast enhancement in the left parapharyngeal fat area. its sharp margination seems most consistent with a benign neoplastic process (question neurogenic tumor). this location would be very unusual for a lymph node or metastatic disease, as was suggested on the previous report. conclusion: findings suggest that there is residual tumor in the region of the right temporal lobe surrounding the right temporal , with mild residual entrapment of this portion of the right lateral ventricle, as described above. pathology pending at time of discharge brief hospital course: the patient was admitted to the neurosurgery service with an intraventricular mass in the icu for close monitoring. he was started on decadron and dilantin. an was obtained to further characterize the lesion. a staging ct of the torso was obtained which showed metastasis to the lungs, left hilum, and spine. he was hydrated with bicarb fluids and given mucomyst for renal protection prior to the ct scans. on hd#2 he was transferred to the neuro step down unit. a wand study was obtained for image guidance of the resection. he was taken to the or for resection of the brain mass on hd#5. he tolerated the procedure well and initially recovered in the pacu. he was extubated in the pacu without difficulty. he was then transferred to the neurosurgery step down unit. on pod#1 a repeat was obtained which showed no bleeding. he was then transferred to the floor. on pod#2 his diet was advanced, his foley was removed and he was seen by pt/ot. his decadron was weaned to 2 mg tid. he was seen by oncology and radiation oncology who recommended follow up in the brain tumor clinic and the biologics clinic. these appointments were set up for the patient. his antibiotics were stopped on pod#4. on pod#5 he was tolerating a regular diet, he had had a bowel movement, he was voiding without difficulty and he was cleared by pt for home. he was discharged home with follow up instructions. medications on admission: none discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain or fever. 2. atenolol 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*0* 3. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po tid (3 times a day). disp:*90 capsule(s)* refills:*0* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 5. dexamethasone 2 mg tablet sig: one (1) tablet po tid (). disp:*90 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: brain tumor discharge condition: stable discharge instructions: discharge instructions for craniotomy/head injury ?????? have a 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, excessive bending ?????? you may wash your hair only after sutures and/or staples have been removed ?????? you may shower before this time with assistance and use of a shower cap ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? if you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered ?????? clearance to drive and return to work will be addressed at your post-operative office visit call your surgeon immediately if you experience any of the following: ?????? new onset of tremors or seizures ?????? any confusion or change in mental status ?????? any numbness, tingling, weakness in your extremities ?????? pain or headache that is continually increasing or not relieved by pain medication ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f followup instructions: please return to the office in days for removal of your staples/sutures call to schedule an appointment please call to schedule an appointment with dr. to be seen in 4 weeks. additional appointments: provider: phone: date/time: 2:35 provider: , md phone: date/time: 4:00 clinic on at 3pm. they will send you a letter with instructions procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain diagnoses: compression of brain secondary malignant neoplasm of brain and spinal cord secondary malignant neoplasm of lung personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow 

Answer: The patient is high likely exposed to