The 21-year-old defending champion was in a class of his own as he won in 14 minutes and 34.04 seconds to shatter his own European record, set at last year's world championships in Russia, by a massive 5.63 seconds.
Only China's Olympic champion Sun Yang, who won gold in the same pool in 2012 with a world record time of 14:31.02, has swum faster in the distance.
Paltrinieri was inside the world record pace between the 1,100 to 1,400 split times.
His team mate Gabriele Detti took a distant silver in 14:48.75 with Ukraine's Mykhaylo Romanchuk finishing third in 14:50.33.
(Reporting by Alan Baldwin, editing by Ed Osmond)
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