I have a T420 and have major heating issues with it playing games. I've tried everything: thinkpad fan control that turns the fan up to 7000RPM, clearing everything out with compressed air, replacing the thermal paste..
After a few years of observations, I think the problem may lie in software.. It seems like when I'm playing games and what not my CPU gets turboboosted, which stays there until it reaches about 90C, when it gets severely throttled, killing framerate and all. I use linux, so right now I have several scripts that goes and disables turbo boost. However, even at that point, it still will boost the CPU when running certain GL applications... Not sure why.
In fact, I've noticed this issue on all Sandybridge laptops I own/have encountered: the 2011 MBP, a dell inspiron... Ivy bridge computers seems to have no issue with this (W530, 2012 MBP).