PARIS (CNN) – An ailing Novak Djokovic exited the French Open to inspired underdog Marco Cecchinato on Tuesday in a thrilling encounter at Roland Garros.

The latest player to be hindered by injury at the French Open, Djokovic received a medical timeout for what appeared to be a neck or shoulder problem at the end of the first set, and fell 6-3 7-6 (7-3) 1-6 7-6 (13-11) to the 72nd-ranked Italian in nearly three and a half hours.

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Cecchinato converted on his fourth match point in the gripping fourth-set tiebreak, his backhand return looping in as the Serb served and volleyed. Djokovic wasted three set points in the tiebreak and also couldn’t serve out the set at 5-3.

Novak Djokovic

Novak Djokovic waves to spectators as he leaves the court after his defeat by Marco Cecchinato during their men’s singles quarterfinal match on Day 10 of the 2018 French Open tennis tournament in Paris on June 5, 2018. (credit: CHRISTOPHE ARCHAMBAULT/AFP/Getty Images)

The 12-time grand slam winner entered the French Open with momentum after an elbow injury and loss of motivation. When the dust settles, he might consider the fortnight to be a positive, yet he was the prohibitive favorite against Cecchinato.

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Cecchinato, combining power, finesse and stellar movement, became the lowest-ranked men’s semifinalist at the French Open since Andrei Medvedev in 1999. His “dream” continues, two years after being handed an 18-month ban for match fixing by Italy’s tennis federation. The ban was later overturned.

“Am I dreaming? Maybe I’m sleeping,” Cecchinato told the crowd. “I don’t understand.”

Cecchinato next faces Dominic Thiem, who beat second-seed Alexander Zverev 6-4 6-2 6-1. Zverev also received a medical timeout for a leg injury and was visibly hampered against the Austrian.

On Monday, Serena Williams withdrew from her high profile clash with Maria Sharapova due to a pectoral injury, and Lesia Tsurenko quit after two games of her encounter with Garbine Muguruza.

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