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 man with metastatic renal cell cancer to the thyroid, left clavicle, left femur, upper thoracic spine, lower thoracic spine, mid lumbar spine, and l5 spinous process, also soft tissue mass at the t2-t3 spinous process and pedicles, as well as subpleural nodular densities. the patient went to mri to followup on ct of chest, abdomen, and pelvis done on for restaging of disease. this reveals soft tissue masses involving upper thoracic spine, l3 vertebral body which prompted a mri. findings prompted decision to have patient come to the emergency department for evaluation. symptoms include right scapular pain and right shoulder pain and weakness from prior. the patient also has occasional left lateral thigh cramp, but no lower extremity weakness or bladder or bowel incontinence. past medical history: 1. metastatic renal cell cancer diagnosed by thyroidectomy on . 2. left clavicle fracture. 3. stage iv renal cell carcinoma clear cell type. 4. status post xrt to right shoulder. 5. status post left nephrectomy. 6. hypothyroidism. 7. childhood asthma. medications: 1. mineral oil prn. 2. colace 100 mg q day. 3. levoxyl 75 mcg qod and 150 mcg qod. 4. oxycontin 10 mg . allergies: no known drug allergies. physical examination: examination revealed a temperature of 99.1, blood pressure 118/70, heart rate 96, respiratory rate 18, and o2 saturation is 98% on room air, weight is 176 pounds. in general, the patient is lying in bed in no acute distress. heent: mucous membranes moist. lungs are clear to auscultation bilaterally. heart regular, rate, and rhythm, no murmurs, rubs, or gallops appreciated. abdomen is soft, nontender, nondistended, positive bowel sounds. extremities: no pedal edema. neurologic: cranial nerves ii through xii are grossly intact. motor are 4+/5 right deltoid, right triceps. lower extremities 5/5 strength throughout. coordination: difficulty with fine finger motions bilateral in the upper extremity and tension tremor in the upper extremities in finger-to-nose test. deep tendon reflexes, toes are downgoing bilaterally, and slightly increased left patellar reflex over right patella, 2+ to 3+ reflexes otherwise. laboratories: laboratories revealed a hematocrit of 44.8, creatinine of 1.4 on admission. mri of the spine revealed t2 epidural soft tissue mass with flattening of the thecal sac with approximately 50% narrowing of the spinal canal indications of metastatic marrow infiltrate l1, 3, 4, 5, and sacrum. hospital course: the patient received xrt for the spinal metastases throughout the hospitalization. the patient was evaluated by orthopedic surgery and deemed a candidate for prophylactic rod placement in the femur. the patient underwent the prophylactic rod placement on , and did well postoperatively. the patient was ambulating on postoperative day one, and the pain was well controlled. the patient was also continued on decadron for the spinal metastases and started on lovenox for prophylaxis after the rod placement. hospital course was otherwise uneventful, and the patient was discharged in good condition on . follow-up instructions: the patient will follow up with dr. and dr. and dr. all on . discharge medications: 1. decadron 4 mg po q6h. 2. oxycontin 10 mg . 3. oxycodone 5 mg 1-2 tablets q4-6h prn breakthrough pain. 4. neurontin 300 mg q hs. 5. lovenox 30 mg for 16 more days. 6. protonix 40 mg q day. 7. levothyroxine 125 mcg q day. discharge instructions: the patient incidentally was found to have a tsh of 10 and the dose of levoxyl was increased to 125 mcg q day. the patient should have a followup tsh. dr., 12-871 dictated by: medquist36 procedure: internal fixation of bone without fracture reduction, femur local excision of lesion or tissue of bone, femur diagnoses: unspecified acquired hypothyroidism secondary malignant neoplasm of other specified sites personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow personal history of malignant neoplasm of thyroid 

Answer: The patient is high likely exposed to