If your public IP from your ISP is 12.13.14.15, and your internal block is 192.168.0.0/24, then your ISP can send a packet to 12.13.14.15 destined for 192.168.0.7, and without a firewall your router will happily forward it. An attacker who can convince intervening routers to send traffic destined for 192.168.0.7 to 12.13.14.15 (and these attacks do exist, particularly over UDP) can also do that.
Okay, so not only do you have to create a bogus packet, you have to convince every piece of equipment in between you and the end user to collude with it, in the hopes that the final router is so woefully misconfigured as to act upon it?