Italy's World Cup build-up suffered a major blow when midfielder Riccardo Montolivo broke his leg against Ireland, while in other Brazil 2014 warm-ups Holland beat Ghana and Greece held Portugal.
AC Milan captain Montolivo was injured in the early stages of the friendly at Fulham's Craven Cottage following a crunching tackle from Ireland defender Alex Pearce yesterday.
Skippering Italy on the night he needed several minutes of treatment and was seen mouthing "it's broken" before eventually being carried off.
"Montolivo has what we suspected, a broken tibia," Italy physician Enrico Castellacci said.
"I haven't seen the X-ray yet to evaluate the extent of it but for a broken bone you can expect surgery."
Montolivo played seven times in Italy's World Cup qualifying campaign and had been expected to be a key member of the team in Brazil.
To make matters worse for Italian coach Cesare Prandelli, he also saw Fiorentina midfielder Alberto Aquilani, who had come on for Montolivo, forced off with an injury before half-time.
Prandelli, whose side kick off their World Cup campaign against England on June 14, has yet to prune his provisional 30-man squad down to a final group of 23 and he will now have to decide who will replace Montolivo.
In Rotterdam, Holland continued their build-up to the finals with a 1-0 win over fellow Brazil-bound Ghana, Manchester United striker Robin van Persie's fifth minute goal proving decisive.
The Dutch, who open their World Cup campaign against titleholders Spain in a rematch of the 2010 final, have only one further prep lined up, against Wales on Wednesday in Amsterdam.
