File photo: Former Italian PM and leader of the right-wing party Forza Italia Silvio Berlusconi leaves the polling station after casting his vote in Milan on May 26, 2019. Italian ex-prime minister Silvio Berlusconi died at age 86. AFP
The billionaire media mogul was admitted to a Milan hospital on Friday for what aides said were pre-planned tests related to his leukemia.
His admission came just three weeks after he was discharged following a six-week stay at Milan's San Raffaele hospital, during which time doctors revealed he had a rare type of blood cancer.
Berlusconi had suffered ill health for years, from heart surgery in 2016 to a 2020 hospitalisation for coronavirus. Despite being re-elected to the Senate last year, he was rarely seen in public.
But he remained the official head of his right-wing Forza Italia party, a junior -- and occasionally troublesome -- partner in Prime Minister Giorgia Meloni's coalition government.
Berlusconi led Italy three times between 1994 and 2011, for a total of nine years, wooing voters with a promise of economic success only to be forced out as a debt crisis gripped his country.
But his influence extended well beyond politics, thanks to his extensive TV, newspaper and sporting interests, while his playboy antics kept him in the headlines even in his final years.
"Silvio Berlusconi made history in this country," ex-prime minister Matteo Renzi said on Facebook.
"Many loved him, many hated him: everyone today must recognize that his impact on political but also economic, sporting and television life was unprecedented," he said.
Berlusconi is survived by his 33-year-old girlfriend, Marta Fascina, two ex-wives and five children, some of whom help run his empire, recently estimated to be worth some seven billion dollars.
While it is too soon for details of his funeral, Berlusconi built a Pharaoh-inspired marble mausoleum at his villa in Arcore, near Milan, to house his family and friends when they die.
Berlusconi began his career as a real-estate magnate before investing in television channels which broke the mould in Italy, featuring shows particularly popular with housewives, later a pillar of his electorate.
He portrayed himself as both the messiah and a martyr and enjoyed widespread popularity, though detractors accused him of cronyism, corruption and pushing through laws to protect his own interests.
His fans admired his plain speaking, although many Italians were acutely embarrassed by his crude jokes and insults on the international stage, as well as his endless legal cases, which resulted in one conviction for corporate tax fraud.
While Italy's economy floundered, the self-professed playboy was hosting his notorious "bunga bunga" sex parties, which triggered a series of trials that were only wrapped up in recent months.
In 2010, 17-year-old Karima El-Mahroug, known as "Ruby the Heart Stealer", claimed to have been paid by Berlusconi for sex. He was later also accused of bribing witnesses to lie about the parties, although he was ultimately acquitted.