Primary central nervous system tumors originate from the neuroepithelial tissue, being the most common the gliomas. Nonspecific symptoms can include a headache, seizures, pyramidal syndrome and disorders of mental functions. Imaging studies provide critical information for the characterization of the location extension and other radiological features. The study of these neoplasms with nuclear medicine allows assessing more accurately the biological component of the lesion. Through the use of multimodal neuronavigation systems, it is possible to perform the integration of these different types of diagnostic imaging, increasing the precision and safety of surgical procedures. We present the case of a patient with a diffuse glioma of the right frontal lobe with a pyramidal syndrome which was operated by awake-craniotomy and multimodal neuronavigation-assistance. Currently, at 36 months of follow-up, the patient has full clinical recovery and no evidence of disease on PET scan.