26th February 2025

A 52-year-old gentleman with a background of metastatic renal cell carcinoma and COPD phones his GP

A 52-year-old gentleman with a background of metastatic renal cell carcinoma and COPD phones his GP due to several episodes of vomiting. He complains of increasing nausea over several weeks, with vomiting after breakfast for the last 5 days. He has been able to eat lunch and dinner normally. On further questioning, he also describes a several-week history of severe headaches, worse in the mornings, that he thought were related to the stress of his cancer diagnosis. He has no pain elsewhere, is opening his bowels and passing wind normally, and has not had any infective symptoms. Fundoscopy reveals optic disc swelling.

Which diagnostic test is most likely to reveal the underlying diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.