Italy beat Japan 42-14 in Sapporo on Sunday in a game that saw fly-half Paolo Garbisi stretchered off in the second half after a heavy collision.
Garbisi was apparently knocked unconscious after taking a blow to the head in an accidental clash with Japan centre Dylan Riley.
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Italy scored three first-half tries to take control of the game but Riley scored either side of the interval to hand Japan a lifeline.
Solid kicking restored Italy’s cushion before two late tries from the visitors put the result beyond doubt.
It left Japan head coach Eddie Jones still looking for his first win since returning to the job at the start of the year, having also lost at home to England and Georgia.
Japan’s next games will be in the new-look Pacific Nations Cup, which starts in August.
“Credit to the Italy team, they came out and put us under some real pressure early,” said Riley.
We’ve got to look forward, review this, have two weeks to refresh and then come back stronger.”
Ange Capuozzo scored Italy’s first try in the eighth minute, punching a hole in the Japan defence and charging through to touch down.
Scrum-half Martin Page-Relo added another five minutes later after Ross Vintcent had pounced on a loose ball to set his team-mate up near the line.
Italy were temporarily reduced to 14 men when Vintcent was yellow-carded in the 31st minute.
But the visitors still managed to increase their lead minutes later when Capuozzo danced through the Japan defence before laying the ball off for Andrea Zambonin to score.
Japan finally got on the scoreboard when Riley broke away to score in the last action of the first half.
The centre grabbed another just minutes after the restart, intercepting an Italian pass before racing clear of the opposition defence.
Italy had another player yellow-carded when Jacopo Trulla was sent to the sin bin, and there was a scary moment when doctors rushed onto the pitch to attend to the stricken Garbisi.
The fly-half’s brother Alessandro Garbisi, on as a substitute, scored in the 73rd minute after a mix-up in the Japan defence, before Vintcent added another after the hooter.
The game concluded Italy’s Pacific tour, where they lost to Samoa and beat Tonga.