Supposed you have 2 domain controllers, DC1 and DC2.
For whatever reason, two different people go to create a new user account - one does it on DC1, the other on DC2.
Presumably, the two accounts now have the same username, but different SIDs.
What happens when the DC's try to synchronize the next time?
You get a replication conflict.
One of the accounts will get to keep the desired name, and the other will be automatically renamed to something else to resolve the conflict.
This very example is actually used here, and the relevant parts are pasted below.