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: penicillins attending: chief complaint: gross hematuria, 50-pound weight loss major surgical or invasive procedure: open left radical nephrectomy history of present illness: 54 y/o female w/large left renal mass, s/p mediastinoscopy showing metastatic rcc. is a previously healthy patientn who, two years ago, noted one episode of gross hematuria, which quickly resolved. more recently, she has had a 50-pound weight loss from 210 to 160 pounds over the past six months. she has noted some fullness in the left upper quadrant, but no actual pain and only requires very occasional tylenol for this. imaging was performed, which revealed a very large left renal mass consistent with renal cell carcinoma. on , she underwent a mediastinoscopy with lymph node biopsy, which was consistent with metastatic carcinoma. she has noted severe fatigue and although she can walk at least 10 minutes, her performance status is lower than normal for her, probably ecog 1. no gross hematuria. no urinary infections or other urinary symptoms. she has occasional night sweats, no fever, occasional cough, no hemoptysis. past medical history: pmh/psh: mediastinoscopy , ectopic pregnancies, right knee surgery, , laparoscopy to evaluate for multiple miscarriages, gerd. social history: a 40-pack-year smoking history, quit in . no alcohol. she is a housewife. they have a 12-year-old daughter. family history: family history is unremarkable. physical exam: nad, a&ox3 no respiratory distress abd: soft, nt, nd, left flank incision: c/d/i, ct site: c/di ext: no c/c/e pertinent results: 06:56am blood wbc-7.4 rbc-3.54* hgb-9.2* hct-28.1* mcv-79* mch-26.1* mchc-32.9 rdw-16.5* plt ct-281 06:56am blood glucose-110* urean-11 creat-1.3* na-136 k-4.4 cl-104 hco3-27 angap-9 brief hospital course: patient was admitted to urology after undergoing an open left radical nephrectomy. no concerning intraoperative events occurred; please see dictated operative note for details. the patient received perioperative antibiotic prophylaxis. the patient was transferred to the sicu from the pacu due to hypotension. on the evening of pod 0, hct was 25. she was transfused 1 unit overnight and was on pressors to keep sbp>90. her epidural was lowered and changed to plain bupivicaine and dilaudid pca, and her bp improved by pod 1. on pod 1, pain was well controlled on pca and epidural, hydrated for urine output >30cc/hour, provided with pneumoboots and incentive spirometry for prophylaxis, and she ambulated once. on pod 1, pressors were also weaned off, and chest tube was removed with no complications. cxr showed no pneumothorax. on pod2, she was transferred to the floor and diet was advanced. on pod3, epidural and foley was removed and she was transitioned to oral pain meds. the remainder of the hospital course was relatively unremarkable. the patient was discharged in stable condition on pod 4, eating well, ambulating independently, voiding without difficulty, and with pain control on oral analgesics. on exam, incision was clean, dry, and intact, with no evidence of hematoma collection or infection. the patient was given explicit instructions to follow-up in clinic with dr.. medications on admission: tylenol prn pepcid prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 3. famotidine 20 mg tablet sig: one (1) tablet po q24h (every 24 hours) as needed for heartburn. 4. acetaminophen 500 mg tablet sig: 1-2 tablets po q8h (every 8 hours) as needed for fever, pain. 5. ibuprofen 600 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. discharge disposition: home discharge diagnosis: metastatic rcc/left renal mass s/p open left radical nephrectomy discharge condition: stable alert and oriented ambulatory discharge instructions: -you may shower but do not bathe, swim or immerse your incision. -do not lift anything heavier than a phone book (10 pounds) or drive until you are seen by your urologist in follow-up -tylenol should be your first line pain medication, a narcotic pain medication has been prescribed for breakthough pain >4. replace tylenol with narcotic pain medication. max daily tylenol dose is 4gm, note that narcotic pain medication also contains tylenol (acetaminophen) -do not drive or drink alcohol while taking narcotics -colace has been prescribed to avoid post surgical constipation and constipation related to narcotic pain medication, discontinue if loose stool or diarrhea develops. -resume all of your home medications, except hold aspirin until you see your urologist in follow-up -if you have fevers > 101.5 f, vomiting, or increased redness, swelling, or discharge from your incision, call your doctor or go to the nearest er -do not eat constipating foods for 2-4 weeks, drink plenty of fluids followup instructions: schedule an appointment with your primary care physician to have your staples removed on . call dr. office (;for follow-up and if you have any questions (page dr. at ). procedure: incision of abdominal wall nephroureterectomy division or crushing of other cranial and peripheral nerves regional lymph node excision diagnoses: malignant neoplasm of kidney, except pelvis hypovolemia secondary and unspecified malignant neoplasm of intrathoracic lymph nodes secondary malignant neoplasm of retroperitoneum and peritoneum secondary malignant neoplasm of adrenal gland 

Answer: The patient is high likely exposed to