Pharmaceutical firm Johnson & Johnson (J&J) has been ordered to pay more than $55m (£40m) in compensation to an American woman who says its talcum powder caused her ovarian cancer.
Gloria Ristesund, 62, said she used J&J talc-based powder products on her genitals for decades.
The company - which faces about 1,200 similar claims - insists its products are safe and says it will appeal.
Researchers say links with ovarian cancer are unproven.
In February, Johnson & Johnson paid $72m (£51m) in a similar case.
Ms Ristesund was diagnosed with ovarian cancer in 2011 and had to undergo a hysterectomy and related surgeries. Her cancer is now in remission.
Following a three-week trial in a Missouri state court, she was awarded $5m in compensatory damages and $50m in punitive damages.
Jere Beasley, whose firm represents Ms Ristesund, said his client was gratified with the verdict. The jury's decision should "end the litigation", he said, and force J&J to settle the remaining cases.
Analysis: James Gallagher, health editor, BBC news website
Is talc safe?
There have been concerns for years that using talcum powder, particularly on the genitals, may increase the risk of ovarian cancer.
But the evidence is not conclusive. The International Agency for Research on Cancer classifies talc used on the genitals as "possibly carcinogenic" because of the mixed evidence.
Why is there any debate?
The mineral talc in its natural form does contain asbestos and does cause cancer. However, asbestos-free talc has been used in baby powder and other cosmetics since the 1970s. But the studies on asbestos-free talc give contradictory results.
It has been linked to a cancer risk in some studies, but there are concerns that the research may be biased as the studies often rely on people remembering how much talc they used years ago. Other studies have argued there is no link at all and there is no link between talc in contraceptives such as diaphragms and condoms (which would be close to the ovaries) and cancer.
Also, there does not seem to be a "dose-response" for talc, unlike with known carcinogens like tobacco where the more you smoke, the greater the risk of lung cancer.
What should women do?
The charity Ovacome says there is no definitive evidence and that the worst-case scenario is that using talc increases the risk of cancer by a third.
But it adds: "Ovarian cancer is a rare disease, and increasing a small risk by a third still gives a small risk. So even if talc does increase the risk slightly, very few women who use talc will ever get ovarian cancer."
A J&J spokeswoman said the verdict contradicted 30 years of research supporting the safety of cosmetic talc.
Carol Goodrich said the company intends to appeal and will keep defending its products' safety.
Other cases pending
The case follows another one in February, in which Johnson & Johnson was ordered to pay $72m to the family of a woman who claimed her death was linked to use of the company's Baby Powder talc.
Jackie Fox from Birmingham, Alabama died of ovarian cancer last year, aged 62, having used the talc for decades.
Her family argued that the firm knew of talc risks and failed to warn users.
J&J is appealing against that verdict, which sparked renewed interest in talc-powder lawsuits. Lawyers accuse J&J of failing to warn that talc was linked to an increased risk for ovarian cancer - a claim J&J denies. There are 1,200 other cases pending.
J&J shares were down 18 cents in after-hours trading to $112.57.