I guess it would be possible to design an ATX size motherboard with a RPi4 compute module slot (once CM4 becomes available). The PCIe bus would allow all sorts of peripherals. Don't expect any performance though.
You could build a fully blown Linux desktop peripheral wise, just don't expect desktop performance.
I did this with an external PCIe 'splitter'/switch board: https://twitter.com/q3k/status/1225560443927891971
It worked, kinda. After a kernel rebuild with the drivers I wanted and dtb bumps to allow for more PCIe MEMBAR space i was able to get multiple devices (IIRC 10GbE and SATA controller) to work simulataneously, just very slowly.
huh! huh! can you have enough BAR space for an AMD GPU to run?
Rockchip RK3399 is infamous for having too little for GPUs..
How many PCIe lanes are on this connector? Is this a full 16x slot? I assume since it has a very limited amount of PINs I'd assume it's just a 1x.
The next obvious step is hooking up this to a PLX chip. Duplicating the number of lanes available even if there's no additional bandwidth could really open up doors.