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: large liver mass major surgical or invasive procedure: :right hepatic trisegmentectomy and median sternotomy. history of present illness: this is a 50 year-old woman presenting with a large spindle cell carcinoma in her right hepatic lobe. the patient initially presented in with what she thought was a "pulled muscle". she felt a bulge in her ruq which she thought might have been a hernia. she was seen in the melanoma clinic for evaluation of a possible melanoma metastasis. she was found to have a hepatic spindle cell carcinoma and was referred to the transplant surgery clinic. she presented to clinic this morning to initiate evaluation for a possible hepatic lobe resection. dr. decided to admit the patient for preop workup and abdominal imaging. the patient denies abdominal pain, fevers, chills, shortness of breath, chest pain, nausea, vomiting constipation, diarrhea, hematochezia, melena, jaundice, scleral icterus or pruritis. she does state that her appetite has been the same but has early satiety. she also states that she gets bilateral lower extremity edema when sitting for long periods of time and cramping in her calves when she drives. she also has some complaints of lower back pain which she partially attributes to her job which requires her to sit for long perids of time. past medical history: slightly elevated blood pressure, melanoma on her back s/p wide excision w/ advancement flap , lf great toe crush injury s/p surgical intervention in ' and '. social history: denies alcohol use, tobacco use and recreational drug use. she is currently married. family history: n/c physical exam: tc 96.5 hr 87 bp 135/84 rr 18 sats 96% ra wt 57.9kg gen: wd, thin female in nad, pleasant, cooperative heent: ncat, eomi, no scleral icterus cv: regular rate and rhythm, no murmurs, rubs or gallops resp: clear to auscultation bilaterally, no wheezes, rales or rhonchi abd: firm in ruq extending into rlq, nondistended, nontender, scaphoid in appearance, minimal bowel sounds auscultated, dull to percussion over ruq and extending midway into rlq, ext: mild non pitting edema in bilateral lower extremities, no cyanosis, no clubbing neuro: alert and oriented x 3 pertinent results: on admission: wbc-12.3* rbc-4.05* hgb-11.3* hct-34.5* mcv-85 mch-27.9 mchc-32.8 rdw-14.5 plt ct-443* pt-14.2* ptt-28.2 inr(pt)-1.2* glucose-75 urean-14 creat-0.8 na-139 k-4.3 cl-100 hco3-28 angap-15 alt-59* ast-63* alkphos-466* amylase-63 totbili-0.7 lipase-44 albumin-3.5 calcium-9.6 phos-3.9 mg-2.2 iron-18* caltibc-308 ferritn-338* trf-237 tsh-2.2 t3-96 free t4-1.3 brief hospital course: 50 y/o female admitted with liver mass. initial abdominal ct report as follows: 1. large heterogeneously enhancing lesion replacing segments 4a/4b/ of the liver, supplied by the right hepatic artery. probable occlusion of the right portal vein. the left portal vein is patent. 2. there is a heterogeneously enhancing lesion within the right lobe of the thyroid corresponding to that described on recent pet-ct which is concerning for malignant process. 3. there is a small amount of simple-appearing free pelvic fluid and a heterogeneously enhancing structure within the lower pelvis which may represent a fibroid uterus; pelvic ultrasound is recommended for further assessement as indicated. a transvaginal u/s was performed showing simple 2.2-cm cyst in the left ovary and free fluid in the pelvis. no other pelvic abnormalities were identified. on she underwent thyroid biopsy of right lower pole. results were as follows: atypical single cells with increased nuclear:cytoplasmic ratios, irregular nuclear contours and prominent small nucleoli. abundant neutrophils. -note: the atypical cells are too few to characterize. clinical correlation is recommended. cardiac echo was performed in anticipation of surgery which was wnl with ef > 55% on day 4 of the hospitalization she spiked a fever to 101.9. she was pan-cultured with blood and urine cultures no growth on multiple exams. id was consulted. she was treated with 5 days on unasyn and fluconazole. on she was taken to the or by drs and for right hepatic trisegmentectomy and median sternotomy by dr. . per dr operative note there was a large mass replacing much of the segments , ivb, v and viii, as was seen on the pre-op ct. the left lateral segment was free of tumor by inspection, palpation and by intraoperative ultrasound. a right trisegmentectomy with clear gross margins was done. please see the operative note for surgical detail. biopsies taken at the time of surgery were returned with the following: -poorly differentiated spindle cell and epithelioid tumor, consistent with metastatic malignant melanoma. note: the lesion is focally present at the cauterized parenchymal resection margin. -immunostains of the tumor cells within the areas of epithelioid differentiation are diffusely and strongly positive for hmb45, mart 1 and s100, and negative for actin, desmin, lca, ema and cytokeratin cocktail. patchy staining for ckit is identified. within the spindle cell foci, the tumor cells are negative for all of the above immunostains (all controls are satisfactory). given the patient's history of previously excised invasive malignant melanoma of the right mid-back (which also demonstrated epithelioid differentiation within the vertical growth phase; see prior report s02-), the tumor morphology and immunophenotype support a diagnosis of metastatic malignant melanoma. -portal lymph node, excisional biopsy: one lymph node with no malignancy identified. in the post op period, she remained afebrile. drains were tested for bilirubin on pod 5 and found to be consistent with serum, the medial drain was removed on pod 7. the lateral drain continued to have outputs as high as 1900cc per day. iv fluid was restarted on pod 9 at 1/2 cc/cc as weight was down 8 kg after the surgery. the jp drainage trended down and on pod 13 ()drainage was 850cc. the jp was removed. vital signs remained stable. abdomen was non-distended with dry incisions. she was ambulatory and tolerating a regular diet with supplements. of note, she did experience intermittent nausea unrelieved by zofran. iv reglan was used with improvement. nausea resolved. she also experienced quite a bit of clear yellow fluid drainage from the previous left groin line site. this was sutured and drainage stopped. site remained without redness. she was discharged home off antibiotics. she will follow up in 1 week with dr. on . follow up with the melanoma clinic was to be arranged. medications on admission: mvi, ca, mg, zn, vitc discharge medications: 1. oxycodone 5 mg tablet sig: one (1) tablet po q3h (every 3 hours) as needed. disp:*30 tablet(s)* refills:*0* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): stop if loose stool/diarrhea. disp:*60 capsule(s)* refills:*2* resume vitamins previously taking prior to hospitalization discharge disposition: home discharge diagnosis: malignant melanoma, s/p liver resction discharge condition: good discharge instructions: please call dr. office if you have a fever > 101, chills, nausea, vomiting,abdominal distension, diarrhea, inability to take or keep down medications, yellowing of skin or eyes. monitor the incision for redness, drainage or bleeding. you may shower, pat incision dry. do not apply lotion/ointment to incisions. no heavy lifting do not drive if you are taking pain medication make sure you are taking in adequete nutrition. try to have at least 3 supplements daily, especially if you do not have a good appetite. try to take at least 1500 calories daily. followup instructions: , md phone: date/time: 2:30 dr. phone: date/time: 2:30 provider: , md, phd: date/time: 11:40 md, procedure: partial hepatectomy simple excision of other lymphatic structure closed [percutaneous] [needle] biopsy of thyroid gland other division of bone, scapula, clavicle, and thorax [ribs and sternum] diagnoses: malignant neoplasm of liver, secondary personal history of malignant melanoma of skin portal vein thrombosis nontoxic uninodular goiter 

Answer: The patient is high likely exposed to