Former head of the Cosa Nostra Sicilian mob died in hospital in central Italy after slipping into an ‘irreversible coma’, Italian media say.

The ANSA news agency said on Monday that Messina Denaro, 61, died in the L’Aquila Hospital in central Italy after slipping into an “irreversible coma” over the weekend.

The former head of the Cosa Nostra Sicilian mob was seeking treatment for colon cancer at the time of his arrest. He was initially held in a maximum-security prison but transferred to the L’Aquila Hospital in recent weeks when his condition worsened.

Messina Denaro had requested no aggressive medical treatment, ANSA reported, adding that medics had stopped feeding him after he was declared to be in a coma.

The son of a mafioso, Messina Denaro was born in the southwestern Sicilian town of Castelvetrano in 1962. He followed his father into the mob and at 15, was already carrying a gun.

Police say he carried out his first killing when he was 18.

The Castelvetrano clan was allied to the Corleonesi, led by Salvatore “the Beast” Riina, who became the undisputed “boss of bosses” of Cosa Nostra thanks to his ruthless pursuit of power.

Nicknamed “U Siccu” or the Skinny One, Messina Denaro became Riina’s protege and showed he could be just as pitiless as his master, picking up 20 life prison terms in trials held in absentia for his role in an array of mob murders.

These include the 1992 killings of anti-mafia prosecutors Giovanni Falcone and Paolo Borsellino – crimes that shocked Italy and sparked a crackdown on the Sicilian mob, as well as bombings in Rome, Florence and Milan in 1993 that killed 10 people.

Messina Denaro was also held responsible for the kidnapping of Giuseppe Di Matteo, 12, to try to dissuade the boy’s father from giving evidence against the mafia.

The boy was held for two years and then murdered.

Dubbed by the Italian press as “the last Godfather”, Messina Denaro himself once claimed to have murdered enough people to fill a cemetery.

He went into hiding in 1993 as a growing number of turncoats started providing details of his role in the mob, but investigators believe he rarely wandered far from Sicily.

He was caught in the Sicilian capital, Palermo, on January 16, outside a private clinic for cancer patients.

Police said they honed in on the former mafia boss after receiving a tip that he was sick. They weeded out other potential suspects of a similar age and condition, partly by checking the database of the national health system.

According to medical records leaked to the Italian media, he underwent surgery for colon cancer in 2020 and 2022 under a false name.

Messina Denaro never married but was known to have a number of lovers.

He wrote that he had a daughter but had never met her.

Despite his notoriety, prosecutors have always doubted that Messina Denaro became the Mafia “boss of bosses”, saying it was more likely that he was simply the head of Cosa Nostra in western Sicily.