Mario Balotelli has been sent home from the Confederations Cup due to a strained thigh, leaving Italy without its top striker for both the semifinal vs. Spain and the final or third-place match.

Having already been ruled out of the semifinal a day earlier, Italy coach Cesare Prandelli decided to send Balotelli home Monday after consulting with team physician Enrico Castellacci.

Castellacci said it wasn't worth risking further damage for Balotelli and that AC Milan's medical staff will take over treatment.

As for Andrea Pirlo, who sat out Saturday's match with Brazil due to a muscle problem, Castellacci said he was "optimistic" he could play vs. Spain on Thursday. Also, midfielder Riccardo Montolivo has fully recuperated from a knock to the head.

"Pirlo continues to work out and we're optimistic but we need to evaluate him day by day and we won't decide whether he can play until the last minute," Castellacci said.

Alberto Gilardino would seem to be Balotelli's logical replacement if Prandelli sticks with his single-striker lineup. Or he could use several forwards such as Emanuele Giaccherini, Stephan El Shaarawy, Sebastian Giovinco, Alessio Cerci or Alessandro Diamanti.

"Without Mario we'll have to work much more collectively so we'll work more on that," Prandelli said. "We have a few problems but the squad is responding well despite the difficulties."