User [Paslis] on the bit-tech forums has been documenting his desk/PC case build.
The design, called Next Level, is a completely integrated system. The desk, PC, and monitors are all integrated with the design. Paslis started with some 3D renders of the finished product, then he got to fabricating the frame. This involved laser cutting aluminum, welding, and woodworking. Definitely not the kind of skills all PC builders have.
The PC components are sunken into the desk behind a sheet of glass. Fans are mounted in strategic spots, but most of the cooling is handled by a water cooling rig that, again, is completely integrated with the design. In fact, the reservoirs for the water are stylish custom pieces of wood and metal fit for any art gallery.