We present a case of an 81-year-old female diagnosed with metastatic carcinosarcoma from a primary peritoneal Müllerian malignancy after endovascular biopsy of a large mass within her left renal vein extending into the inferior vena cava (IVC) after workup for increasing back and abdominal pain over one and a half months. Biopsy of the mass was performed with digital subtraction angiography using a combination of transjugular liver biopsy set as well as suction aspiration. We propose that suction aspiration of an intravascular mass is a safe and efficacious procedure to obtain accurate diagnosis.