ROME (AP) -- Italy's No. 1 fugitive, Matteo Messina Denaro, a convicted Mafia boss who ordered some of the nation's most heinous killings, was arrested Monday at a private clinic in Sicily after three decades on the run, Italian paramilitary police said.
Messina Denaro was captured at the Palermo clinic where he was receiving treatment for an undisclosed medical condition, according to Carabinieri Gen. Pasquale Angelosanto, who heads the police force's special operations squad.
Italian news reports said Messina Denaro was being treated for cancer. During an evening news conference, authorities did not give details about his health. Investigators said he was unarmed and dressed like a typical patient at the upscale clinic, wearing a watch worth at least 30,000 euros (about $33,000).
"He didn't resist at all," Carabinieri Col. Lucio Arcidiacono told reporters.
A young man when he went into hiding, Messina Denaro is now 60. With a power base near the western Sicilian port city of Trapani, he was considered Sicily's Cosa Nostra top boss even as a fugitive.
He was the last of three longtime top-level Mafia bosses who managed to elude capture for decades. Hundreds of police officers were tasked over the years with tracking him down.
On Monday, a pair of Carabinieri officers, each holding an arm, walked Messina Denaro down the front steps of the clinic to a waiting black van in pouring rain. He was dressed in a brown leather jacket trimmed in shearling, a matching white-and-brown skull cap and his trademark tinted glasses. His face looked wan and he stared straight ahead.
Palermo Chief Prosecutor Maurizio De Lucia told reporters that the fugitive had used the pseudonym Andrea Bonafede and had an Italian identify card in that name. He used the alias, whose surname roughly means "good faith" in Italian., to book a morning appointment at the clinic.
The fugitive's health condition helped investigators zero in on him, according to Angelosanto. "It all led to today's date (when) he would have come for some tests and treatment" at the clinic, the Carabinieri general said.
Tried in absentia and convicted of dozens of murders in the last decades, he faces multiple life sentences that he is expected to serve out in a maximum security prison and under the particularly restrictive conditions Italian law reserves for top organized crime bosses.
His convictions include helping to mastermind with other Cosa Nostra bosses a pair of 1992 bombings in Sicily that killed top anti-Mafia prosecutors Giovanni Falcone and Paolo Borsellino, Falcone's wife and several of their bodyguards.
He also was convicted in the grisly murder of a Mafia turncoat's young son, who was abducted and strangled before his body was dissolved in a vat of acid.
"We captured the last of the massacre masterminds" of the early 1990s Mafia killings, prosecutor De Lucia said. "We have partially paid a debt to the victims of the Mafia."
Italian Premier Giorgia Meloni tweeted that Messina Denaro's capture is a "great victory of the state, which shows that it doesn't surrender in the face of the Mafia."
Monday's arrest came 30 years and a day after the Jan. 15, 1993, capture of convicted Mafia "boss of bosses" Salvatore "Toto" Riina, in a Palermo apartment after 23 years on the run. Messina Denaro went into hiding during the summer of that year as the Italian state stiffened its crackdown on the Sicilian crime syndicate following the murders of Falcone and Borsellino.
The Italian Mafia boss who set the record for the longest time on the lam was Bernardo Provenzano. He was captured in a farmhouse near Corleone, Sicily, in 2006 after 38 years as a fugitive. Once Provenzano was in police hands, the hunt focused on Messina Denaro, who managed to elude arrest despite numerous reported sightings.
That all three top bosses were ultimately arrested in the heart of Sicily while they conducted clandestine lives for decades won't surprise Italy's police and prosecutors. Law enforcement have long said that such bosses rely on contacts and the confidentiality of fellow mobsters and complicit family members to move them from hideout to hideout, supply food, clean clothing and communication, and a code of silence known as "omerta."
But Messina Denaro, besides staying in hideouts in Sicily, also traveled abroad while a fugitive, including to Marseille, the French port city, where he underwent surgery some years ago, according to investigators.
Riina and Provenzano lived out the last years of their lives in the strictest of Italian prison conditions reserved for unrepentant organized crime bosses and refused to cooperate with investigators.
Messina Denaro was believed to have enjoyed a more comfortable lifestyle in his decades hiding from police, leaving some to speculate whether he might agree to cooperate with prosecutors in exchange for more lenient prison conditions.
During his years on the run, he had a series of lovers and passed time by playing video games, according to Italian media reports. Messina Denaro is believed to have fathered two children while a fugitive.
One of his girlfriends was arrested and convicted of having hidden him for a time while he was a fugitive. But while he had a weakness for women, Messina Denaro could be cruel; Italian media reported that he strangled a woman while she was pregnant.
Right after he went into hiding, Messina Denaro sent a letter to his then-girlfriend that Italian news agency ANSA said read: "You'll hear talk about me, they will paint me like the devil, but it's all falsehoods."
Wary of being located through cellphone use, Mafia bosses frequently resort to handwritten notes known as "pizzini." When Provenzano was nabbed in his rustic, almost primitive, hideaway in the countryside, police found a stash of such notes.
On Monday, Italian state TV transmitted what it said was an audio recording of a 1993 appearance by Messina Denaro before a Sicilian court. A judge sought to confirm his identity and asked basic questions to fill out documents.
When asked his occupation, he replied "farmer" and added that his brother was a banker and his four sisters homemakers. For his residence, he cited Castelvetrano, a farm town near Trapani which was his crime clan's power base and where he was assured of logistics support during his time as a fugitive, according to investigators.
The brother was convicted years ago of Mafia association. One of the sisters was convicted of helping run the crime clan during Messina Denaro's years on the run, Italian news reports said.
With the crackdown that began in the 1990s against Sicily's Cosa Nostra, the island's mafiosi started losing their dominance in Italy compared to other organized crime syndicates.
While the Sicilian Mafia was significantly weakened by a small army of turncoats, on the mainland, the 'ndrangheta syndicate, based in the "toe" of the Italian peninsula, steadily eclipsed Cosa Nostra in reach and influence.
Unlike Sicily's crime syndicates, the 'ndrangheta draws its foot soldiers based on family ties, leaving it less vulnerable to turncoats. The 'ndrangheta is now one of the world's most powerful cocaine traffickers.
But the Sicilian Mafia still runs drug trafficking operations. Other lucrative illicit businesses include infiltration of public works contracts and extortion of small business owners who are threatened if they don't regularly pay "protection money."
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This story has been corrected to show that Messina Denaro is one of six children, not the father of six children, and his court statements date to a 1993 appearance before a judge.