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: sulfa (sulfonamide antibiotics) / gentamicin attending: chief complaint: metastatic ocular melanoma to the liver major surgical or invasive procedure: : extended right hepatic lobectomy, cholecystectomy, anastomosis of left portal vein to main portal vein, portal vein thrombectomy, roux-en-y hepaticojejunostomy to the left hepatic duct and intraoperative ultrasound. history of present illness: 42-year-old female who underwent a proton beam therapy for an ocular melanoma in . she had recurrence in and again received proton beam irradiation. she has been followed by dr. and on she was noted to have an elevated alkaline phosphatase of 189. a ct scan on demonstrated a 4 cm mass in the dome of the liver in the right lobe (segment 7, 8) and a second 5 cm lesion in segment 4b (medial segment of the left lobe). the lesion in the medial segment is sitting close to the confluence of the right and left portal vein but there is no involvement of the portal vein itself. pre-op mri of brain was negative, and chest ct demonstrated no evidence of pulmonary metastases. she underwent preoperative right portal vein embolization in anticipation of performing a right hepatic trisegmentectomy. she had significant hypertrophy of the left lateral segment by ct scan. past medical history: htn, metastatic ocular melanoma psh: c-section ', l cataract, phtoablation x 2 melnoma eye, s/p portal vein embolization , right hepatic lobectomy, ccy, roux-n-y hepaticojejunostomy, portal vein thrombectomy social history: married. lives in northern with husband and one son family history: mother age 77: htn, father age 79: htn,stroke. maternal grandmother died in her 90s and her paternal grandmother also died in her 90s. paternal grandfather died in his 60s or 70s of an mi. maternal grandfather died of unknown causes. physical exam: vs: 98.2, 115/50 ncat, eomi, moist mucous membranes neck supple without anterior or posterior lad tachycardia, normal s1 and s2, no m/r/g decreased bs at r. base markedly different from the l. base where she is quite clear to auscultation soft, distended, appropriately tender along the r. upper flank. wound c/d/i 2 jp drains in place no cvat 2+ peripheral edema, warm and well perfused. pertinent results: on admission: wbc-11.8*# rbc-3.32* hgb-10.4* hct-29.7* mcv-90 mch-31.4 mchc-35.1* rdw-14.9 plt ct-164 pt-18.3* ptt-99.9* inr(pt)-1.7* glucose-153* urean-10 creat-0.9 na-139 k-5.3* cl-104 hco3-17* angap-23* alt-880* ast-912* alkphos-30* totbili-3.6* albumin-2.6* calcium-9.0 phos-5.1* mg-1.9 on discharge wbc-12.8* rbc-3.18* hgb-9.6* hct-29.9* mcv-94 mch-30.2 mchc-32.1 rdw-16.3* plt ct-322 glucose-109* urean-9 creat-0.6 na-136 k-3.4 cl-101 hco3-27 angap-11 alt-111* ast-43* alkphos-140* totbili-0.9 albumin-2.2* calcium-7.3* phos-2.6* mg-2.1 brief hospital course: 42 y/o female with metastatic ocular melanoma who was taken to the or with dr for extended right hepatic lobectomy, cholecystectomy, anastomosis of left portal vein to main portal vein, portal vein thrombectomy, roux-en-y hepaticojejunostomy to the left hepatic duct and intraoperative ultrasound. per dr note, at the time of exploration, she had a large mass in the dome of the liver that was adherent and superficially growing into the right hemidiaphragm. this lesion was easily separated from the diaphragm and a small portion of the fibrous portion of the diaphragm removed without entering the right chest. there was a large amount of necrotic tumor in the segment viii mass. ultrasound also demonstrated the lesion in the medial segment of the left lobe. no other lesions were seen in the left lateral segment. this was a complicated surgery, she received 9000 ml of crystalloid, 9 units of packed red cells, 1250 ml of albumin, 1000 ml of hespan, 1 unit fresh frozen and made 1100 ml of urine. estimated blood loss was 5000 ml. she was transferred to the sicu for initial post op management. please see the op note for surgical detail. she received an additional 5 units of rbcs while in the sicu, and the her hct remained stable for the rest of the hospitalization. on pod 1 an ultrasound was obtained as liver enzymes bumped significantly to the 3000-4000 range. the ultrasound showed appropriate waveforms in the left portal vein, which is patent. limited waveforms of the left hepatic artery appear normal. there is no fluid collection or ascites. impression: expected post-trisegmentectomy appearance of the left lobe of the liver. the liver enzymes started to trend down by pod 2 and continued to do so throughout the hospitalization. although not normal they were much improved by day of discharge. she was transferred to the regular surgical floor on pod 3. morphine dosing was backed down for oversedation. she was then able to start working with pt, start taking pos with good tolerance and having return of bowel function. jp medial drain had around 400 cc output, lateral drain was always less than 100. a t tube cholangio was done on pod 10 showing contrast filling the jejunostomy loop. the tip of the t-tube is directed away from the biliary system and has likely been dislodged. no extravasation of contrast was seen. the drain was capped. the lateral drain was removed, the medial drain was left to jp bulb drainage. of note, the biopsy revealed: liver, right lobe: metastatic melanoma, extending to within 1 mm of posterior resection margin. diaphragmatic nodule: metastatic melanoma. the patient was discharged to a local hotel with vna coverage as they live in northern . medications on admission: lisinopril 20qd, cyclopentolate 1 drop os qwk, brimonidine 1 drop os lasix 40qd, potassium 2meq qd, caco3 1000bid, tylenol 325prn discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: limit to 7 tablets daily. 2. cyclopentolate 1 % drops sig: one (1) drop ophthalmic 1x/week (sa). 3. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 4. white petrolatum-mineral oil 42.5-56.8 % ointment sig: one (1) appl ophthalmic prn (as needed). 5. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 6. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 7. morphine 15 mg tablet sustained release sig: one (1) tablet sustained release po every 4-6 hours as needed for pain: hold for sedation. disp:*25 tablet sustained release(s)* refills:*0* 8. calcium carbonate 500 mg tablet, chewable sig: two (2) tablet, chewable po twice a day as needed for take away from mealtime. 9. lasix 20 mg tablet sig: two (2) tablet po once a day for 10 days. disp:*20 tablet(s)* refills:*0* 10. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily) for 8 days. disp:*8 tab sust.rel. particle/crystal(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: metastatic ocular melanoma to the liver. discharge condition: good/stable discharge instructions: please call dr office at for fever > 101, chills, nausea, vomiting, increased abdominal pain, yellowing of skin or eyes, inability to take or keep down food, fluids or medications drink enough fluids to keep urine light yellow in color use nutritional supplements such as ensure if you are not taking enough calories monitor for sedation if taking pain meds you may use up to two grams of tylenol daily for pain control no heavy lifting monitor incision for redness, drainage or bleeding. call if the incision starts putting out more drainage. you may keep a dressing on to be changed at least once daily drain and record the jp drain output. twice daily and more often as needed. report to dr office if it gets more green in color, develops a foul odor or gets cloudy. bring a record of drain output with you to your clinic visit next week. keep the roux tube coiled and under a dressing to prevent pulling shower. change dressings post. do not allow drains to hang without support followup instructions: , md, phd: date/time: 2:20 md, procedure: venous catheterization, not elsewhere classified cholecystectomy suture of vein other cholangiogram anastomosis of hepatic duct to gastrointestinal tract lobectomy of liver incision of vessel, abdominal veins diagnoses: malignant neoplasm of liver, secondary acute posthemorrhagic anemia secondary malignant neoplasm of other specified sites accidental puncture or laceration during a procedure, not elsewhere classified hemorrhage complicating a procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation calculus of gallbladder without mention of cholecystitis, without mention of obstruction abdominal pain, other specified site accidents occurring in residential institution tachycardia, unspecified neoplasm related pain (acute) (chronic) portal vein thrombosis accidental cut, puncture, perforation or hemorrhage during surgical operation personal history of malignant neoplasm of eye 

Answer: The patient is high likely exposed to