I did a major mod on my last case (minor one on this one).
It worked very well.
I cut a 4 1/2" circle on the left rear side of the case (directly across from my cpu, vid card, and pci slots. then I attached a 12v fan w/ a transformer and separate switch on the desk top. I then pulled off an extra drive-bay cover to give it somewhere to exaust to.
it kept everything nice and cool, even my old voodoo3 stopped overheating.
plus I was flying RB 3D at the time so I had the added realizm feature of a 'propwash effect' coming out the front of the box (almost bad enough to require goggles)

I just marked and drilled holes for the mounting bolts, and after laying-out the circle in the case I just cut a hole with a 1" hole-saw, then cut the circle out with tin-snips.
btw- get a sheet of that high-density packing foam (the stuff thats about 1/16 - 3/32 thick) and make a gasket to go between the fan and the case, it makes a huge difference on noise, without it the case just works like a amplifier for the fan noise