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It is essential to know whether there is metastasis to bone and liver in bladder tumor management. However, there have been controversies about value of bone and liver scan. Herein we reviewed 65 cases with bladder tumor in which bone scan and/or liver scan were done. Bone scan was done in 64 cases at diagnosis, and 15 showed abnormal hot spots, among which 8(13%) were true metastasis. So specificity of bone scan was 53% . Of 12 patients with bone metastasis 7 (58%) showed elevated serum alkaline phosphatase, and 2 (17%) complained bone pain. Bone metastasis was found only in patients with invasive tumor, 5 of 29(17%) at diagnosis, 3 of 29(10%) during follow up. Liver scan was done in 19 patients at diagnosis and 1 during follow up, of which 3 showed space occupying lesion, but only 2 of 3 were true metastasis. 2 cases with liver metastasis were found only in patients with invasive tumor and abnormal liver function. We can conclude that bone scan should be done in all patients with invasive bladder tumor and its result should be confirmed by bone survey, but liver scan should be done selectively in patients with invasive bladder tumor and abnormal liver function.
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