The universal block only directly cools the actual GPU chip - that VRAM and other modules are cooled using your case airflow. The other components on the PCB don't generate as much heat relative to the GPU, but if they don't have heatsinks they can/will overheat. That black part on that guy's PCB is a universal heatsink for the VRAM, etc.
I feel like there would be enough space to mount at least one 2x120 rad inside, and any external radiators could just be mounted directly on the case. It would require some drilling, but it should be simple.