A male patient who was 13 years old in 2017 had a hepatic cyst that grew from about 78 mm height (54 × 24 mm) to roughly 112 × 73 mm by 2021, now presents in 2025 with leukocytosis (~13 ×10⁹/L) and is tapering psychotropic medications (Atryline stopped, Zexil 50 mg daily, Preziva dose reduced, Neuroplex reduced to twice daily). What is the clinical significance of the cyst growth, leukocytosis, and medication taper, and what diagnostic steps should be taken next?

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