Full-back David Bortolussi is set to miss Italy's Six Nations trip to Wales.
Full-back David Bortolussi is Italy's key goal-kicker
The Italian's key place-kicker injured his shoulder in training with his French club Montpellier and could miss the rest of the Six Nations.
Wing Kaine Robertson will also miss Italy's clash in Cardiff on 23 February because of a thigh injury.
Alessio Galante replaces Ludovico Nitoglia, who was a late call-up with Calvisano's Paolo Buso, while former captain Marco Bortolami also returns.
Gloucester second row Bortolami missed Italy's first two Six Nations games because of a fractured eye socket.
Bortolussi's absence is a major blow for the Italians as the 26-year-old full-back has kicked all but 10 of Italy's 20 points in this year's Six Nations.
Uncapped 21-year-old full-back Buso and wing Nitoglia, who has 17 caps, have been called up from Italy's A squad.
Italy squad to face Wales on 23 February:
Mauro Bergamasco, Mirco Bergamasco, Marco Bortolami, Paolo Buso, Gonzalo Canale, Martin Castrogiovanni, Carlo Antonio Del Fava, Santiago Dellape, Carlo Festuccia, Ezio Galon, Leonardo Ghiraldini, Andrea Lo Cicero, Andrea Marcato, Andrea Masi, Carlos Nieto, Sergio Parisse (captain), Enrico Patrizio, Salvatore Perugini, Simon Picone, Alessio Galante, Alberto Sgarbi, Josh Sole, Pietro Travagli, Alessandro Zanni