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: history of present illness: this is a 58-year-old male with metastatic renal cell carcinoma who is four years past right radical nephrectomy stage t3b. the patient subsequently in , had two lesions resected from the left posterior lung lobe consistent also with metastatic renal cell carcinoma. he has been followed with serial surveillance ct scans. he had a scan from which showed a lesion in his solitary left kidney approximately 2 cm in diameter. patient had no hematuria, no abdominal pain, no nausea or vomiting, no weight loss, no fever or chills. he had a bone scan done on which showed no metastatic disease and his bun and creatinine at that time were 18 and 1.1. he presented for evaluation of the left renal mass and was scheduled for a left partial nephrectomy. past medical history: hypertension. past surgical history: right nephrectomy with ivc thrombectomy in , left lung resection in . medications: hydrochlorothiazide 25 po q.d., norvasc 10 mg po q.d., zestril 20 mg po q.d. social history: patient drinks three to four glasses of wine per night. physical examination: on initial physical examination, the patient is a well-developed, well-appearing male in no apparent distress. his neck was supple, no masses. his chest was clear to auscultation bilaterally. cardiovascular: regular rate and rhythm. his abdomen contained no palpable masses. liver and spleen were within normal limits. no hernias were found. he had no palpable lymphadenopathy. his anus and perineum were within normal limits. his genitourinary exam was normal. his prostate was approximately 40 grams. he was neurologically intact. laboratories: white blood cell count was 7.2, hematocrit 39.6, platelets 242,000. urinalysis was negative. his pt was 13, ptt 22.9, inr 1.2. his sodium was 138, potassium 4.3, chloride 99, c02 24, bun 15, creatinine 1.0. ast and alt were 28 and 27 respectively. alkaline phosphatase was 40. his total bilirubin .7. albumin 4.4. brief hospital course: mr. was admitted on . he underwent a left partial nephrectomy under general endotracheal anesthesia. intraoperative, he had significant blood loss of approximately two liters for which he received 1200 cc of crystalloid. he had a number one jp drain and a foley catheter placed. there were no complications. he was transported to the recovery room intubated and in stable condition, however, he was requiring pressors to keep his pressure up. his initial blood gases in the post anesthesia care unit were 7.28, 42, 149, 21 with a base excess of 6. based on this and his pressor requirement, he was kept intubated and transferred to the intensive care unit. overnight, he was weaned off of his pressor and weaned off of the ventilator. he was extubated on postoperative day number one without incident and transferred to the regular floor. patient had received three units of blood intraoperatively and one unit in the post anesthesia care unit. on postoperative day one, his hematocrit was 27.7, however, on postoperative day number three, it progressively decreased to 22, 23.5 on repeat. 02 was given, one unit of packed red blood cells, hematocrit increased to 24 and was 25.8 on discharge. he was kept on ancef perioperatively. he remained afebrile throughout his hospital course. he was not discharged on any antibiotics. his urine output remained good throughout his hospital course and his bun and creatinine were 18 and 1.3. his diet was advanced on postoperative day number five, he was ambulating independently and tolerating a regular diet and his pain was controlled on oral pain medication. he initially had some high output from his jp drain about 600 cc per day. jp creatinine was checked which was 2 and his drain was taken out on postoperative day number six. condition of discharge: patient is afebrile, hemodynamically stable, tolerating a regular diet, ambulating independently, tolerating oral pain medication. discharge diagnoses: 1. renal cell carcinoma. clear cells variant. 2. status post left partial nephrectomy, a solitary kidney. 3. hypertension. discharge medications: 1. dilaudid 2-4 mg po q. 4 hours prn pain. 2. colace 100 mg po b.i.d. 3. iron sulfate 325 mg po t.i.d. follow-up: patient is to follow-up with dr. . , m.d. dictated by: medquist36 procedure: partial nephrectomy diagnoses: malignant neoplasm of kidney, except pelvis secondary malignant neoplasm of lung 

Answer: The patient is high likely exposed to